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
- ...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
$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,...Suggested
$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...Suggested- ...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$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$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- ...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
$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- ...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...
- 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:...
- ...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
- 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
$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$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$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- * Active RN license* CPR certification* Clinical... ...love for patient-centered care, especially in a home... ...for patient welfare and coordinates care between patients,... ...strategies and procedures utilizing community resources as... ...record/utilization review of medical records and...Weekly payDaily paidImmediate startFlexible hoursNight shiftWeekend workWeekday work
- Job Description RN- Medical Surgical, Coral Springs... ...professional nursing care in accordance with physicians... ...care activities, coordinates care planning, collaborates... ..., and repositioning. Reviews patient admission... ...and interpret data and utilize the information to make...Part timeFlexible hoursShift workNight shift
- ...Registered Nurse (BHRN)****Angels Care Home Health**Angels Care Home... ...to home bound patients. Coordinates care with the interdisciplinary... ...and OASIS within 48 hours* Utilize appropriate behavioral health... ...including responding to QA and coder reviews and performing clinical...
- ...Reporting to the Clinical Care Manager, the Hospice RN- Field is responsible for... ...nursing homes. The Hospice RN utilizes assessment, intervention,... ..., collaborates, and coordinates with colleagues and management... ...nursing care plans which are reviewed daily and updated as...Local areaRelocation packageShift work
- ...renders professional nursing care in accordance with... ...for physicians' use. Coordinates care planning, collaborates... ..., and repositioning. Reviews patient admission... ...accredited school of Nursing RN Licensure within the... ...and interpret data and utilize the information to make...Daily paidFlexible hoursShift work
- ...is accountable to plan, coordinate, provide, intervene, and evaluate the care of assigned oncology patients... ..., and repositioning. Reviews patient admission... ...accredited school of Nursing RN Licensure within the... ...and interpret data and utilize the information to make...Daily paidFlexible hoursShift workNight shift
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