RN Utilization Review & Care Coordination
$62.7k - $100.4kCareSource
A healthcare organization is seeking a Clinical Care Reviewer II responsible for processing medical necessity reviews and assisting with care coordination activities. Candidates need to hold an Associate's degree in nursing and have at least three years of clinical experience. The role offers a compensation range of $62,700.00 - $100,400.00 per year and can qualify for performance-based bonuses, all while upholding a culture of collaboration and belonging. #J-18808-Ljbffr CareSource
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the RN Utilization Review & Care Coordination in Florida, NY vacancy
$73.86k - $96.02k
...concurrent, retrospective chart review for clinical financial resource utilization. Coordinates with the healthcare team for optimal... ...Licenses & Certifications: MCG Care Guidelines Specialist.... ...their non-leadership role as an RN. However, they are required to complete...SuggestedLocal area- ...is seeking a dedicated Utilization Management professional... ...licensure as either an LPN or RN and a minimum of 2 years... ...include reviewing patient clinical information, coordinating with healthcare teams, and... ...on teamwork and patient care. #J-18808-Ljbffr Itlearn...SuggestedFull time
$73.86k - $96.02k
Baptist Health South Florida is seeking a qualified individual to conduct chart reviews for clinical financial resource utilization. The role requires effective communication with healthcare teams and various agencies to optimize patient outcomes. Qualifications include...Suggested$26.41 - $51.49 per hour
...California, MO is seeking a Clinical Member Services Reviewer. The role includes assessing clinical service... ...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, ranging...SuggestedHourly payMolina Healthcare
Florida, NY2 days ago$71.1k - $97.8k
...insurance company is seeking a Utilization Management Registered Nurse to utilize... ...clinical nursing skills for coordinating medical services and benefit... ...clinical experience and a Compact RN license. Responsibilities include making care determinations, excellent communication...SuggestedRemote job- ...healthcare services company is seeking a Clinical Care Reviewer based in Doral, FL. The role requires a current FL RN licensure and a minimum of 3 years of nursing... ...or ICU. Candidates should have experience with Utilization Review, familiarity with Interqual Criterion,...
$68.13k - $119.52k
...Jobs is looking for a Registered Nurse to monitor admissions and perform medical necessity reviews in Altamonte Springs, Florida. The ideal candidate will collaborate with the care team and ensure proper patient status authorization. The required qualifications include...$32.76 - $57.47 per hour
...disciplinary rounds to review changes in patient status... ...and level of care, and discharge plans for... ...to ensure timely care coordination and progression of care... ...Prior Care Management/Utilization Management experience (... ...Certifications Registered Nurse (RN) Certified Case...Full timeWork experience placementLocal areaMonday to FridayFlexible hoursWeekend workDay shift- ...highest quality in‑home care services that improve... ...You Be Doing Concurrent review of patient’s clinical... ...for medical necessity Coordinates patient care needs with... ...updates to Manager of Utilization Management for review... ...licensure as a LPN or RN Minimum 2 years of prior...Full timeTemporary work
$62.7k - $100.4k
Job Summary Clinical Care Reviewer II is responsible for processing medical... ...health services) and care coordination for members, as well as... ...accredited registered nursing (RN) degree program required... ...health experience preferred Utilization Management/Utilization Review...Hourly payWork at office$65.58k - $108.65k
...Description Delivers safe care and demonstrates regard... ..., the Institutional Review Board, and the Office of Sponsored Programs. Coordinates the work of support staff... ...to maintain licensure. Utilizes positive interpersonal... ...Registered Nurse (RN) [Required] Basic Life...Full timeWork experience placementWork at officeLocal areaFlexible hoursShift work$26.41 - $51.49 per hour
...for clinical member services review assessment processes. Responsible... ...integrated delivery of care across the continuum. Contributes... ...Molina care model. Adheres to utilization management (UM) policies and procedures... ...experience. Registered Nurse (RN). License must be active and...Hourly payWork experience placementWork at officeRemote workMolina Healthcare
Florida, NY2 days ago$71.1k - $97.8k
Job Summary The Utilization Management Registered Nurse uses... ...and support the coordination, documentation and communication... ...manages post-acute care services, including Skilled... ...Registered Nurse (RN) license in your state... ...management/utilization review for a health plan or acute...Bi-weekly payTemporary workRemote work$68.13k - $119.52k
...continued stay medical necessity reviews. Maintain thorough knowledge... ...with the multidisciplinary care team regarding patient status... ...authorizations for in-house patients, utilizing daily commercial authorization... ...: Registered Nurse (RN) [Required] Basic Life Support...Full timeWork experience placementLocal areaShift work- ...staffing firm is seeking a Registered Nurse for Concurrent Review in Florida. The role involves telephonic review of... ...to ensure appropriate medical necessity and care levels. Candidates must have an active RN license in Florida and 2+ years of clinical experience...Full timeWork at officeMonday to Friday
$80k - $90k
...Responsibilities*** Performs clinical reviews on medical records to maintain... ...necessary.* Experience with utilization management systems or clinical... ...making tools such as Millimen Care Guidelines (MCG) or InterQual.... ...*** Active unrestricted RN license #J-18808-Ljbffr Performant...Remote workFlexible hours- Background Screening Information - Position Summary The RN Unit Care Coordinator is responsible for supervising, implementing, coordinating, and managing patient care through interpersonal contact with patients, families, nursing staff, and others on his/her respective...
$33 - $39 per hour
.../hr The VITAS Telecare RN is a member of the interdisciplinary... ...and families by utilizing the nursing process, the VITAS Palliative Care Guide, and Telecare... ...with LPN/LVN’s. Coordinates all service delivery after... ...patient/family interaction. Reviews all entries in the...Contract workWeekend workVITAS Healthcare
Florida, NY3 days ago- ...Healthcare Solutions is hiring a Supervisor, Clinical Review Nurse in New York. This full-time role involves overseeing Utilization Management activities and leading a clinical team. Candidates should possess an active RN license, a minimum of five years of clinical...Full time
- The MedElite Group is looking for a responsible LPN Care Coordinator in Hollywood, FL, to ensure the accuracy of patient records and collaborate with the team to provide high-quality care. This is a full-time in-office role that requires an LPN certificate and excellent...Hourly payFull timeWork at office
$32.76 - $57.47 per hour
...disciplinary rounds to review changes in patient status... ...and level of care, and discharge plans for... ...to ensure timely care coordination and progression of care... ...Prior Care Management/Utilization Management experience (... ...Certifications: Registered Nurse (RN) (Required) Certified...Work experience placementReliefLocal areaFlexible hoursShift work- Registered Nurse- Hospice (Patient Care Coordinator) page is loaded## Registered... ...- Currently licensed as an RN in State of Florida. -... ...organizational decisions - Manages and reviews the budget for errors and... ...Performance Improvement and Utilization Review functions.locations:...
- ...Nurse Clinical Competency Coordinator (2601235) Registered... ...of post-acute care. PruittHealth will help... ...procedures and attitudes and reviewing medical records and documentation... ...to facility partners utilizing the principles of Adult... ...an accredited/approved RN program. MINIMUM...
- ...highest quality in-home care services that improve... ...You Be Doing As a Utilization Management Nurse, you... ...compliance. By continuously reviewing and auditing patient... ...for medical necessity Coordinates patient care needs... ...licensure as a LPN or RN Minimum 2 years of prior...Full timeTemporary work
- Wound Care Registered Nurse (RN) - $5,000 Sign on Bonus Valencia Hills Health and Rehabilitation Center... ...Care Specialist The Wound Care Nurse coordinates treatment to provide comprehensive... ..., genitourinary, and dermal systems. Utilizes current wound management theory when...Daily paidRelocation packageShift workNight shiftWeekend work
- ...accident and critical illness insurance, long term care, elder & childcare, auto & home insurance Note : Eligibility... ...Diem, Rotate Position Summary The Registered Nurse coordinates and provides safe care to patients utilizing the nursing process of assessment, planning,...Daily paidFlexible hours
$40 per hour
...Nurse Reviewer PT (20‐30 hours week) – Remote Work Environment Non‐Exempt... ...and regulations. The RN will work closely with the Team... ...with established standards of care and applicable policies Manage... ...claims against industry standards, utilizing research of relevant ICD‐10,...Contract workWork at officeLocal areaImmediate startRemote workHealthcare Quality Strategies
Florida, NY3 days ago$90k - $99k
...DRG Nurse Reviewer Appeals and Hearings- Remote Date: Jan 9, 2026... ...Reviewer Appeals and Hearings to coordinate and perform all appeal related... ...required CEUs to maintain RN license and/or coding certification... ...you bring together people who care deeply about making healthcare...Full timeRemote workWork from homeFlexible hoursGainwell Technologies
Florida, NY3 days ago$85.2k
...You Will Do The Lead Medical Coordinator is an exempt position responsible... ...services for children in care. Additionally, the position is... ...medical information as necessary. Review and maintain current medical... ...Need Licensed Registered Nurse (RN) with a Bachelor’s degree, or...Work at officeLocal areaImmediate startFlexible hours- RN - Hialeah Urgent Care Center (Full Time, Days) - 301442 Job Summary Responsible... ...and delivery of care utilizing nursing processes: assessment... ...assigned patients. Plans, coordinates, and implements a transfer... ...with patients and families to review plan of care and solicits input...Full time
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN Utilization Review & Care Coordination. Be the first to apply!
Related searches
- neuro icu registered nurse Florida, NY
- new grad rn Florida, NY
- nicu rn Florida, NY
- registered nurse nursing home Florida, NY
- new grad rn residency Florida, NY
- rn observation unit Florida, NY
- rn hospice Florida, NY
- outpatient registered nurse Florida, NY
- rn evening shift Florida, NY
- home health rn case manager Florida, NY