Utilization Review Clinician (RN/OT/PT) - Drive Care Decisions
WellSky
WellSky is seeking a Utilization Review Clinician responsible for reviewing medical records to determine medical necessity. In this position, you'll conduct patient evaluations, manage admissions, and collaborate with healthcare providers to support improved health outcomes. The ideal candidate will possess a Bachelor's degree, an active RN, OT, or PT license, and have 4-6 years of related clinical experience. Join WellSky in shaping the future of healthcare and apply today! #J-18808-Ljbffr WellSky
- Santa Barbara Cottage Hospital is looking for a Utilization Review Clinician to ensure that medical necessities are reviewed effectively. This role... ...with physicians and healthcare providers to manage patient care through established guidelines. The ideal candidate will possess...PTS card
- ...physical health. Utilizes the nursing... ...direct patient care. Assists all patients... ...the treating clinician, in accordance... .... Includes review of Provider documentation... ...Intervention; PT/OT; Neurosurgery;... ...skills. Decision making and... ...Current NY State RN License required...PTS cardWork at officeImmediate start
- ...thread” of compassionate care that connects staff and... ...As our Utilization Management Nurse, you will... ...integrity in clinical decision‑making, regulatory compliance... ...you will meticulously review medical records, authorize... ...Collaborates with facility RN Care Coordinators to ensure...Suggested
$30 - $38 per hour
...wellbeing solutions, and comprehensive care navigation together in one place. We serve... .... Learn even more about the work that drives us at personifyhealth.com. Responsibilities Job Summary We are seeking Utilization Review Nurse RN to join our team on a part‑time basis,...SuggestedHourly payFull timePart timeWork at officeRemote workMonday to FridayWeekend work$35 - $45 per hour
...IntePros is seeking a Remote Utilization Review Nurse serves as a key... ...collaboration across teams to optimize care, drive cost‑effective resource... ...requirements. Provide feedback to clinicians on accurate assessments,... ...nursing program (RN, LPN, or LVN). Minimum of two...SuggestedContract workRemote workWeekend work$27.02 - $48.55 per hour
...State Registered Nurse (RN) licensure and be... ...and appropriate level of care in accordance with national... ...necessity and clinical reviews of authorization... ...interdepartmental teams on utilization processes to promote high... ...license (e.g., Nursing, PT, OT). Compensation &...PTS cardHourly payFull timePart timeWork at officeRemote workMonday to FridayFlexible hours$75k
...dedicated Registered Nurse for inpatient utilization review responsibilities. This role requires performing... ...with clinical teams to make informed decisions. Candidates must hold an active RN license and have experience in acute care settings. The starting salary for this...Remote work- ...established industry player in healthcare is seeking a dedicated Utilization Review Nurse to join their team. This role involves conducting... ...reviews to ensure efficient resource use and high-quality patient care. You will collaborate with clinical staff and stakeholders to...
- ...States of America)## This RN Periop Role is PT Days at our Cobb... ...licensed and unlicensed care givers who ensure... ...interdisciplinary rounds, case review, etc); completion of... ...and research utilization to promote safe, quality... ...as part of the decision-making process in evaluating...PTS cardShift work
- ...Medix™ is seeking an experienced RN for a Utilization Review role, allowing you to work from the comfort of home. In this contract-to-hire position... ...and communicate with medical teams to ensure appropriate care levels. Ideal candidates will have at least one year of utilization...Contract workRemote workWork from home
- ...A healthcare staffing firm is seeking a skilled Utilization Review RN to join their team. This fully remote position requires a valid PA RN license and prior experience in insurance utilization review. Responsibilities include conducting clinical reviews, applying evidence...Remote work
- ...CVS Health is looking for a highly skilled Utilization Management Nurse (RN) for a remote position. In this role, you will ensure patients receive appropriate healthcare services through reviews of clinical cases and collaboration with providers. The ideal candidate will...Remote work
- ...Job Description We are seeking an experienced Utilization Review Nurse to join our team in a hybrid role based in Uniondale... ...standards. Participate in case management and care coordination meetings. Qualifications Active RN license in the state of New York. Minimum of 2...Work at officeRemote workMonday to FridayFlexible hours
- ...Humana is offering a remote internship for a Utilization Management Behavioral Health Registered Nurse (RN) Intern. This role supports the National Medicaid team, focusing on clinical reviews and patient care. Candidates must be transitioning military service members or...InternshipWork at officeRemote workWeekday work
- ...internship for a Registered Nurse (RN) in Kentucky, aimed at... ...will involve conducting clinical reviews, communicating with healthcare providers, and documenting decisions. Candidates must hold an active... ...and compliance within the managed care industry. #J-18808-Ljbffr...InternshipRemote work
- ...Village Center for Care, Inc. is seeking a self-motivated RN for the role of Utilization Review Nurse in a full-time, hybrid position located in the New York Tri-State Area. The successful candidate will be responsible for assessing member needs and ensuring high-quality...Full timeRemote work
$64.1 per hour
...Role: Registered Nurse (RN) - Case Manager Comp: $... ...access to home health care. The RN role is the front... ...support our field clinicians faster and more supported... ...care across disciplines. Drive case management... ...and coordinate services (PT/OT/ST/MSW/HHA) to ensure the...PTS cardFull timeMonday to FridayFlexible hoursWeekend work$95.45k - $156.54k
...reputation for quality of care and research. We have... ...(MSHP) is the team driving this transformation within... ...Clinical Coordinator (PT/OT) to assess patient... ...role is responsible for reviewing and evaluating Post-... ...Focuses on inappropriate utilization of services while...PTS cardTraineeship$65 per hour
...Title: Registered Nurse (RN) – Case Management... ...will coordinate patient care, manage resources, and ensure appropriate utilization of healthcare services while... ...planning. Conduct utilization review to ensure appropriate... ...clinical assessment and decision-making skills Excellent...Hourly payWeekly payLocal areaShift work$40.5 per hour
...RN Supervisor / Admission Nurse About Maple Farm... ...control” center for resident care and smooth daily... ...help the Admissions Team review and manage referrals so... ...Collaborate with team SW, PT, OT, ST & Nursing regarding... ...per SW direction. Utilizes clinical and leadership...PTS cardPart timeReliefWeekend work$34 - $40 per hour
...Licensure Required) - Open to LPN's & RN's About the Role Medix is seeking an experienced Utilization Review Nurse to support our mission of improving patient care through home-based health... ...guidelines . Provide feedback to clinicians on medical necessity, homebound status...Full timeRemote work- ...States of America)## This RN Periop Role is PT Days at our Cobb... ...licensed and unlicensed care givers who ensure... ...interdisciplinary rounds, case review, etc); completion of... ...and research utilization to promote safe, quality... ...as part of the decision-making process in evaluating...PTS cardShift work
- ...Sinai Hospital-PT/Nights The Clinical... ...quality care based on nursing... ...in Nursing (ADN) RN who is matriculated... ...Rounding, Medication Review, Discharge Wrap... ...protocol. Utilizes institutional information... ...principles into decision making for... ...continuous learning drive positive change,...PTS cardHourly payTraineeshipLocal areaShift workNight shift
- ...in providing progressive, quality patient care with significant investments in our... ...*40**Position Overview*** Performs chart review of identified patients to identify quality... ...clinical information to conduct continued stay utilization review activities with payers on a daily...Full timeTemporary workPart timeWork at officeLocal areaImmediate startFlexible hoursNight shift
- ...technology and compassionate care. Role Purpose: As an... ...assessments, and data-powered decision supportto identify risks early... ...All) Work seamlessly with clinicians and care teams as one coordinated... .... (One Team, One Body) Drive bold improvements by contributing...PTS card
- RN Clinician Charge - WR ICU (FT, nights) page is loaded##... ...and family-centered care. Is recognized as a change... ...effective delegation utilizing the Synergy model for... ...Completes performance reviews with Nurse Manager... ...Supports administrative decisions and facilitates daily...Shift workNight shift
- ...General Brigham is seeking a Peer-to-Peer Utilization Review Nurse to join the Central Utilization... ...collaborating closely with Physician Advisors and Care Management teams. The ideal candidate... ...a Bachelor's of Science in Nursing, an RN license, and extensive experience in...Remote jobFlexible hours
$105k
...Pediatric Home Care Registered Nurse (RN) Our home care visits run Sunday through... ...patient status Utilize diagnosis coding skills to... ...multidisciplinary care team (PT, OT, aides, physicians) Participate... ...PPS meetings for case review and discharge planning Ensure...PTS card- ...Hour (United States of America) PT, 7p-7a Primary Duties and... ...effective, and independent nursing care using the nursing process. Performs... ...have completed an accredited RN program and obtain RN licensure... ...two years of entering the RN Clinician role. Emory Warner Robins, Perry...PTS cardShift workNight shift
- ...hospital in Arizona is seeking a Utilization Management Nurse to ensure... ...and quality through diligent review of medical records and adept... ...stakeholders to uphold clinical decision-making and regulatory... ...providing comprehensive patient care in a supportive environment....
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