Behavioral Health Utilization Review RN
Molina Healthcare of Illinois
Molina Healthcare seeks a Registered Nurse with an Ohio or compact license to join the Care Review Clinician team. You will provide prior authorization for behavioral health services for the Ohio Medicaid population and bring strong behavioral health experience to a fast-paced, outcomes-driven environment. Responsibilities include reviewing requests for medical necessity, collaborating with medical directors, and ensuring timeliness and regulatory compliance. #J-18808-Ljbffr Molina Healthcare
- ...America) Job Description Summary About UofL Health: UofL Health is a fully integrated... ...Position Summary and Purpose The Utilization Review RN performs activities which support the... ...preferred) Three years’ experience with Behavior Health experience (required for positions...SuggestedWork at officeShift work
- ...Conduct telephonic clinical reviews • Complete PRI & Screen assessments... ...meetings • Coordinate Behavioral Health patient care • Manage... ...Experience with Care Coordination, Utilization review and discharge... ...in Nursing is required -RN Licensed as a Registered Nurse...Suggested
- ...of the Incarnate Word, Dignity Health - St. Bernardine Medical... ...Responsibilities Responsible for the review of medical records for... ...and the Care Coordination staff utilizing evidence-based guidelines and... ...1 year experience. California RN license. AHA BLS Ability to pass...SuggestedRemote work
- ...Hello humankindness Dignity Health’s Mercy Gilbert Medical Center... ...Summary and Responsibilities As our Utilization Management Nurse, you will be... ...day, you will meticulously review medical records, authorize... .... Collaborates with facility RN Care Coordinators to ensure progression...Suggested
- Utilization Review Rn Job type: Travel Profession: RN Specialty: Utilization Review State: NY INFOJINISuggested
- Netsmart is seeking a Registered Nurse with solid utilization management experience to perform ED utilization reviews and admissions screening using established criteria. The role requires adept EMR review, strong clinical judgment, and collaboration with ED physicians...Remote job
- Concierge Home Care is seeking an experienced Utilization Review Specialist (RN) to join our remote home health team. This role emphasizes OASIS review, coding accuracy, QA, and remote documentation audits. The ideal candidate holds an active Florida RN license, OASIS certification...Remote job
$30 - $38 per hour
A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote jobHourly payPart time- UofL Health is seeking a Utilization Review RN in Louisville to support utilization management. The role includes admitting and concurrent reviews, interfacing with physicians and payors, and ensuring compliance with UM criteria and documentation standards. Ideal candidates...
$45 - $50 per hour
...dedicated Registered Nurse Clinical Reviewer for a fully remote position... ...role involves conducting utilization and quality reviews and... ...including paid vacation and health insurance, this position offers... ...programs with an active New York RN license. #J-18808-Ljbffr kozmetickesluzby...Remote jobHourly pay- Ensemble is seeking Virtual Utilization Review Specialists to join our remote team. You will evaluate medical necessity, coordinate with physician... ...utilization of resources. Must hold an unrestricted RN or LPN license and have 3+ years of acute care nursing experience...Remote job
- University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and appropriate care. You...Remote jobFull time
- Registered Nurse (RN) - Behavioral Health We’re seeking a compassionate RN to join our team in a residential... ...provide accurate medical information. Utilize technology systems to document care... ...and conduct quality assurance reviews. Ensure safe storage and disposal of all...Monday to FridayFlexible hoursAfternoon shift
- ...facility in California is seeking experienced nursing professionals to review medical records and ensure appropriate admission status. The role... ...patient admissions. Candidates must have a valid California RN license and at least two years of clinical experience or a Master...Remote work
- Whitecap Search Healthcare Partners is seeking a dedicated RN for a Utilization Review & Quality Improvement role at a community hospital. This position focuses on utilization review responsibilities, working closely with physicians to analyze patient readiness for discharge...
- A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote jobFlexible hoursWeekend workDay shift
- Whitecap Search Healthcare Partners is seeking a dedicated RN for a Utilization Review & Quality Improvement role at a community hospital. This position focuses on utilization review responsibilities, working closely with physicians to analyze patient readiness for discharge...Hourly payRemote work
- ...nights, weekends, or holidays. The position emphasizes clinical reviews to determine if treatments meet criteria, with collaboration... ...US license and 3-5 years of acute care experience, plus mental health or substance abuse expertise. A remote setting is available within...Remote jobMonday to FridayWeekend workDay shift
- Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant documentation and communications...Remote jobWork at office
$56 - $65 per hour
...Registered Nurse (RN) | Behavioral Health Location: New York, NY Agency: MD Nurse Staffing, LLC. Pay: $56 to $65 per hour Shift... ...safely. Maintain a safe therapeutic environment and utilize de-escalation techniques. Collaborate with psychiatrists...Hourly payWeekly payDaily paidPermanent employmentFull timeContract workLocal areaShift workNight shift$35 - $43 per hour
...$43.00/hr Job Title Clinical Review Nurse - Concurrent Review Location... ...in CA or hold an active CA RN license) Duration: 12 months (... ...Concurrent Review will perform utilization management functions to ensure... ...and medical determinations in health management systems. Educate...Remote work- A leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services. Responsibilities include processing authorization requests, ensuring compliance with Medicare guidelines, and collaborating with...Remote job
- Location: Fully remote (PA RN License or Compact including PA Required), Must Reside... ...seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)to... ...using clinical review tools and electronic health records Familiarity with InterQual or...Full timeContract workRemote work
$18k
...opportunities. For more than 50 years, Dignity Health’s Chandler Regional Medical Center has... ...-based concurrent and retrospective utilization review to support and encourage the efficient... ...review outcomes. Collaborates with facility RN Care Coordinators to ensure progression...Full timePart timeLive out$26.01 - $56.14 per hour
...U.S. only) About Us American Health Holding, Inc. (AHH), a division... ...medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, you’ll play a vital role in ensuring... ...Active, unrestricted RN license in your state of residence...Remote jobHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursShift work$35 - $45 per hour
...IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison,... ...to determine the need for continued home health services in alignment with Medicare guidelines... ...professional nursing program (RN, LPN, or LVN). Minimum of two years of...Contract workRemote workWeekend work- A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare... ...license and have experience in utilization review or home health. This contract role offers a chance to manage healthcare...Remote jobContract work
- Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside in PA, DE... ...services. You’ll use advanced clinical judgment to review medical records, validate care plans, and authorize services...Immediate startRemote workWeekend workDay shift
$34 - $40 per hour
...0/hr Remote (Compact 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 services. In this role, you will coordinate and review patient...Full timeRemote work$65 per hour
Job Title: Registered Nurse (RN) - Case Management Location: New... ..., and ensure appropriate utilization of healthcare services while maintaining... .... Conduct utilization review to ensure appropriate level of... ...patient advocacy Benefits Pride Health offers eligible employees...Hourly payWeekly payLocal areaShift work
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