RN: Care Optimization & Utilization Review
Medix™
Medix is seeking an experienced Registered Nurse in Florida to perform utilization review, review medical records, and consult with care providers to determine appropriate treatment based on current research. The ideal candidate holds US RN licensure (or compact state license), a nursing degree, 1+ year in utilization review within managed care, and 1+ year acute care clinical practice; willingness to obtain additional state licenses. #J-18808-Ljbffr Medix™
$1,528 - $1,623 per week
...Registered Nurse (RN) | Utilization Review Location: Tallahassee, FL Agency: GQR Healthcare Pay: $1,528 to $1,623 per week Shift... ...: Registered Nurse (RN) Facility: Short Term Acute Care Estimated Pay: $1528.2 - $1623.2 Duration:13 weeks Management...SuggestedHourly payWeekly payFull timeContract workTemporary workImmediate startShift work- ...cost effectiveness of medical care by applying clinical acumen and... .../urgent and continued stay reviews. • Perform onsite review of emergent... ...care • Educate providers on utilization and medical management... ...Qualifications Qualifications: -RN, BSN preferred. -2+ years of clinical...SuggestedPrivate practiceShift work
- ...seeking a highly motivated and experienced Utilization Review Nurse to join our team. The Utilization... ...patients are receiving appropriate care at the correct level of service. Care Coordination... .... Qualifications Registered Nurse (RN) licensure required; must hold a USRN...SuggestedWork experience placement
- All Jobs > Utilization Review Nurse (Full-Time/ Evening Shift) Full-time Description... ...staff, and interdisciplinary care teams to facilitate... ...patient status determinations and optimize reimbursement while... ...unrestricted Registered Nurse (RN) license. Minimum five (5) years...SuggestedFull timeWork at officeShift workNight shiftAfternoon shift
$31.94 - $43.92 per hour
...Job Description Job Description Care Coordination Perform medical + psychosocial... ...Lead care planning discussions Utilization Management Review medical necessity & admission status... ...(acute care) OR Option 2: 3+ years RN in: Med/Surg Telemetry ICU /...SuggestedRelocation packageShift workWeekend workAfternoon shift- ...profile if interested Title: Clinical Care Reviewer Location : Doral, FL Duration : 3 months... ...Related Skills and Experience: • Current FL RN licensure • Registered Nurse graduated... ...care (e.g. ER, ICU) • Experience with Utilization Review and/or Prior Authorization • Familiar...
- ...UF Health in Florida is seeking an experienced RN to support utilization review and case management. You will assess patient records for medical... ...with clinicians, and ensure compliant documentation to optimize care and discharge planning. The role requires 3+ years in...
- American Traveler is hiring an RN Case Manager for a Case Management department requiring at least 2 years of recent case management... ...Minimum 2 years of recent experience in case management/utilization review required No employment gaps of 90 days or more within the past...Daily paidLocal areaDay shift
- American Traveler, LLC. is hiring an RN Case Manager for a hospital-based case management team in Florida. The role requires active... ..., and at least two years of recent case management or utilization review experience. The position follows a daytime schedule, 8:00 AM to...
- ...Blue Medicare clinical expert to oversee well-being, benefits administration and coordination of quality care for subscribers. You will resolve complex utilization management cases, authorize referrals, and ensure medical necessity per criteria while maintaining detailed...
- You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed... ...Skills Active, unrestricted RN licensure from the United States in... ...to meet business needs 1+ year of utilization review experience in a managed care...
- Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This role collaborates with our Medical Director to perform benefit and medical necessity reviews within...Remote job
$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills... ...processing time frames. (i.e. 10 reviews per day?) You will communicate with... ...Must hold Compact Registered Nurse (RN) license in your state of residence...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workHome office- ...Appeal Specialist is responsible for reviewing payer denials and authoring appeal... ...Necessity denials. Using strong utilization review experience and clinical... ...Certifications Registered Nurse (RN) with at least 3 years of acute care hospital experience Minimum of 3...Work experience placementWork at office
$26 - $33 per hour
...facility and custodial admissions and discharges by utilizing the following processes: The Plan’s daily census... ...practice within the State of Florida Concurrent review experience - 2 year minimum experience Managed Care experience - 1-2 year minimum experience Experience...Private practice- CLINICAL REVIEWER RN Location: Hollywood, FL. Who we are IHCS provides an Integrated Delivery... ...providing the highest quality in-home care services that improve and enhance the daily... ...training program Responsibilities As a Utilization Management Nurse, you will ensure that...Full timeTemporary work
$31.85 - $52.76 per hour
...Adult Medical Telemetry unit caring for patients with complex medical... ...nurse/patient ratio with both RN's and LPN'S and have support... ...departments to coordinate and optimize patient care, ensuring effective... ...Clearinghouse: Applicants may review general information about...Full timeLocal areaShift workWeekend work- ...our team as a Ambulatory Care Nurse. The Ambulatory... ...treatment and technology Utilizes resources to meet... ...medication refills by reviewing clinical information and... ...clinical advice as within RN scope and/or direction... ...Identifies barriers to optimal care, e.g. physical, cognitive...Work at office
- ...enjoys wellness-focused care, patient interaction,... ...modalities designed to optimize health and recovery. Responsibilities... ...Assess clients and review medical history for... ...Therapy sessions. Utilize blood test offerings to... ...Registered Nurse (RN) license in good standing...Part timeWork at officeFlexible hours
$33.11 - $61.6 per hour
...community resource needs. Reviews patient history,... ...physician. Implements care plans through direct patient... ...of home patients. Optimizes daily schedules to support... ...and best practice visit utilization. Assesses physical,... ...Certifications: Registered Nurse (RN) [Required] Driver's...Full timeWork experience placementLocal areaMonday to FridayShift workWeekend work- ...One. Job Title PRN ASC RN Specialty - PACU/Endoscopy... ...the same world-class care provided at Cleveland... ...high-quality care and optimal outcomes. In this role,... ...planning the delivery of care utilizing the nursing process in... ...: Please review the Equal Employment Opportunity...ReliefShift work
- ...or Illinois. We are searching for a new RN to join our team. Our Nurses enjoy the flexibility... ...addition to clinical experience. Please review the roles and responsibilities of this... ..., as applicable, in selecting and utilizing evidence-based criteria and support of clinical...Remote jobHome office
- ...for world‑class health care in Palm Beach County and... .../ Qualifications RN- Current RN licensure in... ...modifying patient care utilizing evidence based practices... ...disciplines to ensure optimal, individualized patient... ...circumstances change. I have reviewed these job requirements...
- ...Hiring: Registered Nurse (RN) - Ambulatory Care | Outpatient Preadmission Testing... ...to surgery or procedures, reviews medical histories,... ...and the care team to support optimal surgical outcomes. All Inclusive... ...year. Essential Functions Utilizes the unique knowledge,...Full timePart timeReliefLocal areaMonday to FridayShift work
- Integrated Home Care Services, Inc. is seeking a Utilization Management Nurse in Florida to ensure... ...services. You will review patient treatment files,... ...unnecessary procedures and optimize outcomes. The role requires... ...state licensure as a LPN or RN, at least 2 years in...
- ...Career with BrightStar Care! Keep your skills sharp... ...ensuring safety, comfort, and optimal health outcomes. Your... ..., and medical history reviews to determine individual... ...and safety protocols. Utilize EMR (Electronic Medical... .... Qualifications Valid RN license in good...Part timeFlexible hoursWeekend work
- ...is seeking a Medication Therapy Management Clinician (RN, LPN, NP) to provide MTM services to patients via... ...healthcare or related experience, with preference for managed care and Medicare exposure. You will assess, optimize, and document medication therapy and collaborate with...
$31.94 - $43.92 per hour
...RN Case Manager Location: Tallahassee, FL Shifts... ...You'll Do: The RN CM Care Coordinator will facilitate... ...supporting a balance of optimal care and appropriate resource utilization. The RN CM Care... ...Nursing, or Utilization Review, preferred Compensation...Full timeRelocationRelocation packageShift workWeekend workAfternoon shift$31.94 - $43.92 per hour
...Permanent role Case Manager RN for client at... ...Job Summary The RN CM Care Coordinator will facilitate... ...supporting a balance of optimal care and appropriate resource utilization. The RN CM Care Coordinator... ...Performs utilization management reviews and communicates...Permanent employmentFull timeShift workDay shiftAfternoon shift$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 work
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