Clinical RN Reviewer: Inpatient Utilization & Compliance
$45 - $50 per hourRadNet, Inc.
RadNet, Inc. is seeking a Clinical Nurse Reviewer focused on auditing the IP UM process to ensure compliance with regulations. The role includes analyzing reports, conducting audits, and collaborating with teams for process improvement. The ideal candidate will have a nursing degree and relevant experience. The position offers a comprehensive benefits package including health insurance and 401(k) options, plus competitive pay ranging from $45-$50 per hour. #J-18808-Ljbffr RadNet, Inc.
$88.85k
.... Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates... ...admissions in any inpatient setting. Performs... ...and concurrent review, and collaborates... ...years of varied RN clinical experience in an acute... ...for health plan compliance with UM or CM. Licenses...Suggested$88.85k
...Utilization Management Clinical Quality Nurse Reviewer RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 9001... ...and review of policies and procedures to certify compliance with regulatory guidelines and mandates. This position...SuggestedFull time- Neuehealth is seeking a Concurrent Utilization Review Nurse in Los Angeles, CA. This vital role involves conducting real-time clinical reviews to ensure the medical necessity of... ...communication with payers, and adhering to compliance guidelines. Candidates should be...Suggested
- Working Nurse in Los Angeles is seeking a Clinical Policy Clinical Coder RN II to ensure accurate medical coding and compliance with regulations. The role requires collaboration... ...to implement policies and oversee utilization management. The ideal candidate has at least...SuggestedFull timeShift work
- A leading healthcare provider in California seeks a Senior Inpatient Coder responsible for accurately coding inpatient and emergency room... ...in this role that aims for the highest quality of coding compliance in a supportive healthcare environment. #J-18808-Ljbffr Houston...Suggested
$55 - $60 per hour
...Overview Clinical Liaison VIPC, Hospice Location: Glendale, CA (office... ...Hospital / field-based compliance visits when there aren't Huntington... ...and communication. Be the Best Inpatient Hospice Clinical Liaison Registered Nurse RN You Can Be If you meet these...Part timeWork at officeRemote workShift workWeekend work- ...are looking for a full-time Inpatient Facility Coder . This is a remote... ...will be responsible for reviewing charts, coding appropriate... ...coder will abstract required clinical information. This position requires... ...5% or greater Proficient in utilizing technology (computer, VPN,...Full timeRemote workFlexible hours
- ...Methodist, the Senior Inpatient Coder position is responsible... ...room, therapy, and/or clinic encounters based upon... ...while maintaining compliance with established rules... ...requests to code or review coded accounts for accuracy... ...as appropriate, utilizing the established physician...Work at office
- ...Healthcare Solutions as an Inpatient Facility Coder (P) , a remote... ...facility clients, including reviewing charts, coding appropriate charges... ...systems. Abstract required clinical information and adhere to... ...% or greater. Proficient in utilizing technology (computer, VPN,...Remote workFlexible hours
- ...RN Clinical Staff Nurse - EmPATH - Full Time Nights $7 Differential... ...as a problem-solving model; utilizing their knowledge and experience... ...patient outcomes. # Reviews all orders on patients and communicates... ...acute adult outpatient or inpatient psychiatric unit, background...Hourly payFull timeShift workNight shift
- ...POSITION SUMMARY The RN Utilization Management (RN UM) functions... ...also include management of the clinical denials process in... ...coordination of documentation for inpatient admissions with continued and... ...hospital stays, and discharge review that determine medical necessity...Full time
- ...POSITION SUMMARY The Clinical Staff Nurse is a skilled and experienced... ...Registered Nurse (RN) responsible for excellence in... ...process as a problem solving model; utilizing their knowledge and experience... ...specific patient population. # Reviews all orders on patients and...Hourly payPart timeShift workNight shift
- ...medical necessity for Inpatient hospitalization. Interacts... ...of care and ensures compliance with federal, state... ...community agencies. Reviews, monitors, evaluates and... ...continuity of care, including Utilization management, Transfer... .... Conducts daily clinical reviews for...Local area
$110k - $120k
Hill Physicians Medical Group is seeking a qualified clinical nurse in Los Angeles, CA, responsible for facilitating smooth transitions... ...care across various levels. The role involves monitoring inpatient utilization, discharge planning, and collaboration with healthcare...$55 - $60 per hour
...Overview Clinical Liaison VIPC, Hospice Location: Glendale, CA (office-location) Position... ...Area: Huntington Hospital / field-based compliance visits when there aren't Huntington... ...the Best Clinical Liaison Registered Nurse RN You Can Be If you meet these...Part timeWork at officeLocal areaRemote workFlexible hoursShift workWeekend work- ...A healthcare solutions company is seeking a full-time Inpatient Facility Coder for a remote position. Responsibilities include assigning diagnostic codes, abstracting clinical information, and ensuring compliance with coding standards. Candidates must have RHIA, RHIT,...Full timeRemote workFlexible hours
- ...A healthcare services provider is seeking a remote Inpatient Facility Coder to handle medical coding for facility clients. Responsibilities include assigning diagnostic codes and ensuring quality standards. Applicants must hold RHIA, RHIT, or CCS certification, have at...Remote workFlexible hours
- Inpatient Medical Coder INNOVA Revenue Group Remote | Full-Time | INNOVA Revenue Group is seeking an... ...ICD-10-CM and ICD-10-PCS codes Ensure compliance with CMS regulations and payer-specific guidelines Review documentation for coding accuracy, compliance,...Bi-weekly payHourly payFull timeContract workRemote work
- ...Inpatient Registered Nurse (RN) Care Manager The Inpatient Registered Nurse... ...of care, resource utilization management and/ or review, discharge planning, documentation... ..., regulatory compliance and patient advocacy.... ...hospitals, over 1,000 clinics and a full range of...Full timeLocal area
$80.6k - $145k
Clinical Data Reviewer - Internal Medicine (US, CAN, UK Only) Syneos Health is a leading fully-integrated... ...Background in clinical monitoring or RN strongly preferred. Direct clinical... .... The Company is committed to compliance with the Americans with Disabilities Act...Contract workInterim roleRemote workFlexible hours- ...Clinical Supervisor, UM Denial Compliance Location: Los Angeles Metropolitan Area Position Type: Hybrid (85% remote... ..., managing daily tasks, performance reviews, and disciplinary actions.... ...accredited Registered Nursing Program; RN preferred. Minimum of five years...Permanent employmentTemporary workRemote work
$74.29k - $111.43k
...NeueHealth delivers clinical care to health consumers... ...The Concurrent Utilization Review (UR) Nurse is responsible... ...role involves assessing inpatient admission and... ...payers, and ensuring compliance with health plan policies... ...Education: Registered Nurse (RN) with an active,...Work at office- RN Clinical Staff Observation Area (COA/Tele) Part Time Nights The Clinical Staff Nurse is a... ...nursing process as a problem solving model; utilizing their knowledge and experience to... ...planning for a specific patient population. Reviews all orders on patients and communicates...Hourly payPart timeLocal areaShift workNight shift
$7,000 per month
...Inpatient Case Manager This position offers a sign on bonus! $10k for RN & $7k for LVN The Inpatient Case Manager... ...of illness, utilizing the appropriate tests... ...needs. Receives and reviews physician's orders;... ...confidentiality at all times in compliance with company policy...Hourly payFull timeCasual workWork at officeImmediate startRelocation packageFlexible hours- ...Inpatient Case Manager The Inpatient Case Manager is responsible for the assessment, treatment... ...patient's current severity of illness, utilizing the appropriate tests and diagnostics,... ...& Licensed Renewal Fees for clinical staff. Exempt: No. If interested and...Permanent employmentFlexible hours
$102.18k
Clinical Policy Clinical Coder RN II Shift: Full Time Pay Range: $102,183.00 (Min.) - $132,838.00 (Mid.... ..., and operationalizing medical and utilization management policies to ensure accurate... ...implementation, and organizational compliance with state, federal, and...Full timeShift work$102.18k
...purpose. Job Summary The Clinical Policy Clinical Coder RN II is responsible for... ...operationalizing medical and utilization management policies to... ...implementation, and organizational compliance with state, federal, and... ...payment, or post-payment review requirements. Define and...- ...Care Manager RN Care Manager RN at Providence... ...for exceptional clinical quality. Be a part... ...care. The Inpatient Registered Nurse (RN... ...of care, resource utilization management and/ or review, discharge planning... ...interventions, regulatory compliance and patient...Daily paidDay shift
$74.16 - $107.75 per hour
Veterans in Healthcare is looking for a Utilization Review Nurse to work in Los Angeles, CA. This role is part of the Utilization Management... ...treatment programs. The ideal candidate will perform clinical reviews, act as a liaison between payors and the treatment team...Hourly payMonday to Friday- ...RN Case Manager We are seeking an exceptionally skilled RN Case Manager... ...opportunity to work in a dynamic inpatient setting where you will plan and... ...timeframes Detail appropriate reviews for assigned patients using our utilization review tool Provide telephonic...Daily paidDay shift
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