RN: Clinical Utilization Review & Care Coordination
Healthcare Support Staffing
A leading healthcare staffing firm is seeking a qualified clinical nurse for a utilization management role. Candidates should possess at least 2 years of clinical nursing experience and a year in utilization management within a managed care environment. The position requires collaboration with various healthcare staff to ensure quality care and involves reviewing medical necessity. Applicants can reach out to the recruitment consultant for further details and to apply for the position. #J-18808-Ljbffr Healthcare Support Staffing
- ...seeking an experienced Registered Nurse (RN) in Florida. The role involves... ...Candidates should have strong experience in utilization review or case management and excellent... ...requires the ability to analyze data and coordinate care effectively within a multidisciplinary...Suggested
$26.41 - $51.49 per hour
...Healthcare in California, MO is seeking a Clinical Member Services Reviewer. The role includes assessing clinical... ...delivery. The ideal candidate has an active RN license and at least 2 years of experience in hospital or managed care settings. Competitive pay is offered,...SuggestedHourly pay- ...LLC seeks an experienced Utilization Review Nurse in New York to provide clinical guidance, drive appropriate level of care, and support revenue cycle... ...medical record assessments, coordinate care with... ...insurers on denials. Requires RN license (US multi-state/compact...Suggested
$65.58k - $108.65k
...Description Delivers safe care and demonstrates... .... Maintains clinical competencies... ...the Institutional Review Board, and the Office... ...Sponsored Programs. Coordinates the work of... ...maintain licensure. Utilizes positive interpersonal... ...Registered Nurse (RN) [Required] Basic...SuggestedFull timeWork experience placementWork at officeLocal areaFlexible hoursShift work- UF Health is seeking an RN Utilization Management professional to evaluate medical records... ...necessity and appropriateness of care. The role involves coordinating with providers, optimizing... ...license with 3+ years in utilization review or case management and strong data-...Suggested
- ...motivated and experienced Utilization Review Nurse to join our team... ...by providing expert clinical guidance, facilitating... ...receiving appropriate care at the correct level of service. Care Coordination: Collaborate with... ...Qualifications Registered Nurse (RN) licensure required;...Work experience placement
- ...compliant medical necessity reviews. This role provides day... ...to established clinical criteria, regulatory requirements... ...expectations. The Utilization Review (UR) Nurse Team... ...and expertise in acute care utilization management... ...Registered Nurse (RN) license. Minimum five...Work experience placementWork at officeShift workWeekend work
- ...system, we're transforming care delivery, advancing clinical outcomes, and empowering... ...instructions. You will maintain and review patients’ records... ...license held, active FL RN license required within 60... ...candidates for our Clinical Nurse Coordinator RN Postpartum opening. We...Temporary workFlexible hoursShift work
- ...effectiveness of medical care by applying clinical acumen and the... ...urgent and continued stay reviews. Perform onsite review... ...telephonically, or onsite to coordinate member care Educate providers on utilization and medical management... ...Qualifications RN, BSN preferred. 2+...Shift work
- TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews, assisting...Remote job
- Become a part of our caring community The Clinical Care Nurse (RN) is a clinic-based nursing role focused on improving... ...Care (TOC), reduce avoidable ED utilization, and drive Medicare Advantage... ...transition support, follow-up coordination, and avoidable readmission prevention...Work at office
$25k
Job Profile Field Care Manager Nurse 2 Job Level Professional... ...our caring community The Clinical Care Nurse (RN) is a clinic-based nursing... ...(TOC), reduce avoidable ED utilization, and drive Medicare Advantage... ...support, follow-up coordination, and avoidable readmission...Full timeApprenticeshipWork at officeMonday to Friday$75k - $95k
Overview Clinical Liaison ( RN / RRT ) Select Specialty Hospital Critical... ...skills, you’ll also coordinate care plans with physicians and... ...or post-surgical stay by utilizing your strong clinical background... ...PT, OT, etc., upon further review. Ability to complete clinical...Full timeWork experience placementMonday to Friday$60.84k - $98.86k
CLINICAL RESEARCH NURSE COORDINATOR II (T234527) The University of Alabama at Birmingham (... ...and physician-scientists, cares for 20,000 patients annually... ...nurse coordinators (CRNC) in review of study documents. To... ...licensed as a Registered Nurse (RN) by the Alabama Board of...Work experience placementLocal areaShift workDay shift- ...healthcare services. Involves coordinating with healthcare... ...maintain compliance with utilization management guidelines... ...for effective patient care and resource utilization... ...) years of utilization review, case management, or third... ...Registered Nurse (RN) license with 3+ years...
$26.41 - $51.49 per hour
...Summary: Provides support for clinical member services review assessment processes.... ...through integrated delivery of care across the continuum.... ...Molina care model. Adheres to utilization management (UM) policies and... ...experience. Registered Nurse (RN). License must be active...Remote jobHourly payWork experience placementWork at office- ## Dialysis Clinical Manager Registered Nurse... ...Fresenius Medical Care, you will ensure that... ...through the coordination of activities with... ...Clinical Manager/Charge RN acting as nurse... ...questions including the review of patient... ...facility staff. • Utilizes knowledge of FMCNA...Temporary workWork at office
- ...At Houston Methodist, the Clinical Documentation Specialist RN position is responsible for improving the... ...physicians, nursing staff, other patient care givers, and medical records coding... ...care hospital setting Coding and utilization review experience preferred Licences and...Permanent employment
$5,000 per month
...dedicated Home Health Clinical Manager to join our team... ...quality, patient-centered care while supporting and... ...improvement meetings, reviews relevant data, identifies... ...oversight of care, coordination of services, and that standards... ...Registered Nurse (RN) in good standing and currently...Full timeWork at officeRelocation packageFlexible hours$90k - $95k
Overview RN Clinical Manager - Compassionate Care Hospice, an Amedisys Company. On‑Site Position - Clermont,... ...clinical operations for the care center Reviews requests for services and... ...care services; works with intake in coordinating patient referrals and admissions...Immediate startMonday to FridayFlexible hoursShift work- Humana Inc. is seeking a Home Health Wound Care Registered Nurse to serve as the clinical wound care expert for our home health team, reviewing wound documentation, evaluating complex... ...healing progress, and participate in utilization management while upholding regulatory...
- ...emergency room and urgent care model, setting a new... ...commitment to quality clinical care that yields outstanding... ...Leadership In coordination with the Hospital, recruit... ...’s timeline and tools Utilize resources from Intuitive... ...hospital partners) Active RN license in the state of...Local areaShift workNight shift
- ...Crawfordville is looking for a Clinical Manager (RN) to join our team! The... ...manages and directs all patient care services and personnel in... ...maintaining the best clinical staff Coordinating referrals and ongoing care... ...further information, please review the Know Your Rights notice...Full time
$75k - $99k
...Palm Beach Lake Worth, FL Clinical Assessment Specialist (RN, PT, OT, SLP) $75,000 - $... ...patients can receive the care and services they need.... ...insurance authorization and/or coordination of benefits necessary to... ...of Business Development. Review and analyze medical records...Work experience placement- ## Eldercare Nurse Clinic... ...high-quality health care.**Since 1949, Mount... ...department leadership, reviews and revises department... ...Oversee the daily coordination and the implementation... ...clinical outcomes, utilization and other financial... ...Certification + Current RN Licensure in State...Temporary workWork at officeLocal areaWeekend work
- ...Palm Beach County is seeking an experienced RN Case Manager to lead an interdisciplinary team and coordinate patient care. The role requires Florida RN licensure (... ...others to ensure appropriate admission status and compliant utilization review. #J-18808-Ljbffr Jupiter Med
$74.7k - $100.7k
...largest provider of advanced wound care services in the United States, treating... ...benefit through our out-patient clinic partnerships The Clinical Coordinator (CC)/Clinical Nurse Manager (CNM) is... ...Experience and Credentials: Current RN (Registered Nurse) license - to maintain...Work at officeRelocation package$35 - $40 per hour
Position: Specialty Clinic Nurse (RN/BSN) Location: 309 La Grande Blvd Lady Lake, FL Job Id: 2083... ...Nurse (RN) to join our dynamic and growing care team in our allergy and immunology... ...information by physical assessments and review Supports Physician and Nurse Practitioner...Hourly payFull timeWork at office- Reporting to the Clinical Care Manager, the Hospice RN‑Field is responsible for providing... ...homes. The Hospice RN utilizes assessment, intervention,... ...communicates, collaborates, and coordinates with colleagues and... ...nursing care plans which are reviewed daily and updated as...Local areaShift work
- Position Summary The Clinic Registered Nurse (RN) is tasked with overseeing the medical care given to patients while implementing high standards of care consistent... ...exchange information. Visual acuity and hand‑eye coordination to perform tasks. Workspace may vary from...Full timeWork experience placementWork at officeShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN: Clinical Utilization Review & Care Coordination. Be the first to apply!

