RN Utilization Review Specialist: Optimize Inpatient Care
Dormont Manufacturing Co
Dormont Manufacturing Co in Georgia is seeking a licensed Registered Nurse (RN) for the Utilization Review Nurse position. This role involves conducting medical record reviews to determine care necessity and collaborating with interdisciplinary teams for patient care planning. The ideal candidate should have three years of hospital nursing experience, an RN license, and knowledge of Medicare guidelines. This position requires effective communication skills and the ability to work independently. #J-18808-Ljbffr Dormont Manufacturing Co
$75k
...Hospital is seeking a dedicated Registered Nurse for inpatient utilization review responsibilities. This role requires performing... ...decisions. Candidates must hold an active RN license and have experience in acute care settings. The starting salary for this position is...SuggestedRemote work$17.44 per hour
Job Posting TitleUtilization Review Specialist IAgency452 MENTAL HEALTH AND... ...IJoin a team that CARES!Here at ODMHSAS, we believe... ...Behavioral Health is recruiting a Utilization Review Specialist. This position... ...psychiatric hospital will feature 106 inpatient beds, an expanded residency...SuggestedWork at officeWeekend work$10k
## Utilization Review RN - PT - Day - Utilization Resource Mgmt Pennington NJApplylocations... ..., quality patient care with significant investments... ...functions which help to optimize lengths of stay, utilize resources... ...for appropriateness for inpatient level of care or observation...SuggestedFull timeTemporary workPart timeWork at officeLocal areaImmediate startFlexible hoursNight shift- ...seeking a full-time remote Licensed Utilization Clinician. The role involves evaluating inpatient medical treatments and performing utilization reviews to facilitate optimal health outcomes for members. Key... ...Candidates must have an active RN license, nursing degree, and at...SuggestedRemote jobFull time
- ...Systems, Inc. is seeking a part-time Ohio Licensed Utilization Review Nurse to conduct admissions and transfers reviews while... ...nursing school, have a minimum of 3 years acute care experience, and possess an active RN license. #J-18808-Ljbffr ProMedica Health Systems,...SuggestedRemote jobPart time
- Boston Medical Center is seeking an RN Appeal Administrator responsible for managing the pre-denial, denial, and appeal processes while... ...teams and payers to secure necessary authorizations and optimize reimbursement. The ideal candidate must have a Bachelor’s degree...
- ...Medix™ is seeking an experienced RN for a Utilization Review role, allowing you to work from the comfort... ...contract-to-hire position, you'll review inpatient treatment plans and communicate with medical teams to ensure appropriate care levels. Ideal candidates will have at...Contract workRemote workWork from home
- ...clinical member services review assessment processes.... ...integrated delivery of care across the continuum. Contributes... ...care model. Adhere to utilization management (UM)... ...hospital acute care, inpatient review, prior authorization... .... Registered Nurse (RN). License must be active...Work at office
- ...thread” of compassionate care that connects staff and... ...As our Utilization Management Nurse, you will... ...you will meticulously review medical records, authorize... ...empathy is paramount for optimal patient care and operational... ...Collaborates with facility RN Care Coordinators to...
$30 - $38 per hour
...wellbeing solutions, and comprehensive care navigation together in one place. We... ...Job Summary We are seeking Utilization Review Nurse RN to join our team on a part‑time basis... ...requests for medical appropriateness; inpatient hospital stay including mental health...Hourly payFull timePart timeWork at officeRemote workMonday to FridayWeekend work- ...community hospital in Arizona is seeking a Utilization Management Nurse to ensure healthcare efficiency and quality through diligent review of medical records and adept communication... ...us in providing comprehensive patient care in a supportive environment. #J-18808-Ljbffr...
- ...institution in the United States is hiring for a Concurrent Review Nurse responsible for performing utilization management activities remotely. The role involves... ...professionals to ensure appropriate patient care. The ideal candidate will be a registered nurse with...Remote work
- ...General Brigham is seeking a Peer-to-Peer Utilization Review Nurse to join the Central Utilization... ...collaborating closely with Physician Advisors and Care Management teams. The ideal candidate... ...a Bachelor's of Science in Nursing, an RN license, and extensive experience in...Remote workFlexible hours
$118.13k - $155.79k
...Hospital is seeking a Case Manager - RN for Inpatient Units. This full-time position involves discharge planning and utilization management for patients in... ...Responsibilities include managing clinical reviews and coordinating post-acute care plans. Candidates should have a...Full time- ...A healthcare staffing firm is seeking a skilled Utilization Review RN to join their team. This fully remote position requires a valid PA RN license and prior experience in insurance utilization review. Responsibilities include conducting clinical reviews, applying evidence...Remote work
$78k - $92k
...TalentLNX LLC is seeking a Utilization Review Nurse for a remote position focusing on evaluating medical necessity of inpatient and outpatient services. Ideal for experienced RNs aiming... ...expertise without direct patient care. The role involves reviewing medical cases...Remote work$18k
...has focused on quality patient care and service to the community.... ...concurrent and retrospective utilization review to support and encourage the... ...in order to achieve optimal clinical, financial, operational... .... Collaborates with facility RN Care Coordinators to ensure progression...Full timePart timeLive out- ...Job Title RN-Utilization Review Nurse (Hybrid, Inpatient) Overview VillageCare is looking for a self‑motivated and passionate RN as Utilization Review Nurse... ...that promote high quality and cost‑effective health care services. Responsibilities Review planned, in‑process,...Full timeWork from home
$85.7k - $128.54k
## Utilization Management Nurse, Lead (Inpatient | Remote | Must have California LVN / RN License)Applyremote type: Fully Remotelocations: Anywhere... ...mold in conventional health care, committed to serving... ...Nurse Lead is responsible for reviewing requests for inpatient and prior...Remote jobImmediate startMonday to Friday- ...Currently seeking a Utilization Management RN . Please see details and qualifications... ...through medical record review to determine medical... ...determine medical necessity for inpatient admissions, continued stays... ...to ensure appropriate care settings. Report utilization...Immediate startRemote workDay shift
- ...Title Responsible for the review and coding of inpatient and/or ambulatory surgery records utilizing ICD-10-CM and ICD-10-PCS or CPT... ...for reimbursement, clinical care assessment, education,... ...applicable) Name: Certified Coding Specialist (CCS) Issuing Agency:...Remote jobFull timeTraineeshipWork at officeLocal areaShift work
$65 per hour
...Title: Registered Nurse (RN) – Case Management... ...will coordinate patient care, manage resources, and ensure appropriate utilization of healthcare services while... ...planning. Conduct utilization review to ensure appropriate... ...and healthcare teams to optimize patient outcomes....Hourly payWeekly payLocal areaShift work$35 - $45 per hour
...IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison,... ...promotes collaboration across teams to optimize care, drive cost‑effective resource utilization... ...professional nursing program (RN, LPN, or LVN). Minimum of two years of...Contract workRemote workWeekend work- Santa Barbara Cottage Hospital is looking for a Utilization Review Clinician to ensure that medical necessities are reviewed effectively. This... ...with physicians and healthcare providers to manage patient care through established guidelines. The ideal candidate will possess...
- EmblemHealth is seeking a Clinical Reviewer in New York to perform... ...'s degree in nursing, a valid RN license, and 4-6 years of nursing... ...Responsibilities include coordinating care, communicating with providers,... ...include certification in utilization management and strong...
- ...Description Job Description REPORTS: Director of Utilization Review DEPARTMENT: Clinical LOCATION : George... ...direction of the Director of Utilization Review, the Specialist will coordinate Medicaid Managed Care authorizations and re-authorizations for clients receiving...Temporary workFlexible hours
$3,017 - $3,112 per week
...Registered Nurse (RN) | Utilization Review Location: West Bronx, NY Agency: GQR Healthcare Pay: $3,017 to $3,112 per week Shift... ...Profession: Registered Nurse (RN) Facility: Short Term Acute Care Estimated Pay: $3017.13 - $3112.13 Duration:13 weeks...Hourly payWeekly payFull timeContract workTemporary workImmediate startShift work$3,017 - $3,112 per week
...Registered Nurse (RN) | Utilization Review Location: West Bronx, NY Agency: GQR Healthcare Pay: $3,017 to $3,112 per week Shift... ...Profession: Registered Nurse (RN) Facility: Short Term Acute Care Estimated Pay: $3017.13 - $3112.13 Duration:13 weeks...Hourly payWeekly payFull timeContract workTemporary workImmediate startShift work- Inpatient Care Manager (RN)- Per-Diem, Days, Atlantic Health Chilton Medical Center... ...role ensures effective utilization and monitoring of... ...collaboration to achieve optimal clinical and resource outcomes... ...guardians. Perform daily chart reviews of Palliative care patients...Hourly payDaily paidFull timeTemporary workPart timeFor contractorsFor subcontractorMonday to FridayFlexible hoursShift workDay shift
$50 per hour
...experienced Registered Nurse Clinical Reviewer for a fully remote position with... .... This role involves conducting utilization reviews and ensuring healthcare... ...have an active New York State RN license and 1-3 years of experience in acute care utilization review. Competitive...Remote jobHourly pay
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