Utilization Review Nurse: Optimize Care & Compliance
Santa Barbara Cottage Hospital
A 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. You'll engage with multiple stakeholders to uphold clinical decision-making and regulatory compliance. The ideal candidate will have strong nursing experience and an understanding of utilization review principles. Join us in providing comprehensive patient care in a supportive environment. #J-18808-Ljbffr Santa Barbara Cottage Hospital
$35 - $45 per hour
...IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison,... ...meet patients’ needs while ensuring compliance with federal, state, and organizational... ...collaboration across teams to optimize care, drive cost‑effective resource utilization...SuggestedContract workRemote workWeekend work$85k - $105.34k
...Utilization Review Nurse Remote; Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 974... ...necessary, cost‑effective, and evidence-based care for members. This role conducts prior... ...across care settings, ensuring compliance with Oregon Health Plan (OHP), Medicare...SuggestedFull timeWork at officeLocal areaImmediate startRemote workMonday to Friday- ...States is hiring for a Concurrent Review Nurse responsible for performing utilization management activities remotely.... ...professionals to ensure appropriate patient care. The ideal candidate will be a... .... This position also emphasizes compliance with regulatory standards and...SuggestedRemote job
- NeueHealth is seeking a Concurrent Utilization Review Nurse responsible for conducting real-time clinical... ...the Medical Director to facilitate compliance with health plan policies. The ideal... ...management. A commitment to high-quality care in the healthcare sector is essential....Suggested
$18k
...focused on quality patient care and service to the... ...serve. Our doctors, nurses, and allied health professionals... ...and retrospective utilization review to support and... ...providers in order to achieve optimal clinical, financial,... .... Ensures compliance with principles of utilization...SuggestedFull timePart timeLive out- A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote jobContract work
$65 per hour
...Title: Registered Nurse (RN) - Case Management... ...patient care, manage resources,... ...ensure appropriate utilization of healthcare services... ...Conduct utilization review to ensure... ...healthcare teams to optimize patient outcomes.... ...necessary. Ensure compliance with hospital policies...Hourly payWeekly payLocal areaShift work- A healthcare solutions company is seeking a Utilization Management Nurse Reviewer to assess the appropriateness of medical services and collaborate with healthcare professionals. This role requires a Licensed Practical/Vocational Nurse with clinical experience and skills...
- ...Utilization Review Nurse VillageCare is looking for a self-motivated and passionate RN as Utilization... ...quality and cost effective health care services. Some of your daily activities... ...complete and accurate documentation in compliance with VCMAX policies and procedures....Full timeWork from home
$35 - $43 per hour
...range $35.00/hr - $43.00/hr Job Title Clinical Review Nurse – Concurrent Review Location: Remote (... ...Review Nurse – Concurrent Review will perform utilization management functions to ensure members receive the right care at the right time. This role focuses on discharge...Remote work$34 - $40 per hour
...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... ...coordinate and review patient authorizations, ensure compliance with Medicare and CMS guidelines, and...Full timeRemote work- ...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 healthcare...Remote work
$85k - $105.34k
...Umpqua-Health seeks a Utilization Review Nurse to evaluate clinical service requests and ensure quality care. This role includes conducting prior authorizations, collaborating with healthcare teams, and ensuring compliance with regulations. The ideal candidate will have...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... ...to utilize their clinical expertise without direct patient care. The role involves reviewing medical cases, collaborating...Remote work- Currently seeking a Utilization Management RN . Please see details... ...active PA license or a Nurse Licensure Compact to... ...advanced clinical judgment to review medical records, validate care plans, and authorize... ...coordination, ensure regulatory compliance, and advocate for members...Immediate startRemote workWeekend workDay shift
- ...in New Jersey is seeking a Quality Management Nurse to oversee patient care quality. This role involves reviewing patient records for treatment appropriateness and... ...license, and experience in clinical nursing or utilization review. The position offers competitive...
- ...player in healthcare is seeking a dedicated Utilization Review Nurse to join their team. This role involves... ...resource use and high-quality patient care. You will collaborate with clinical staff and stakeholders to maintain compliance with healthcare regulations and improve...
$44.67 - $74.44 per hour
...Description Summary: An Infusion Nurse II is a licensed registered... ...intermediate direct patient care to patients in the home, or... ...patient safety with continuity and compliance under a physician’s plan of... ...timelines for billing optimization. Completes all documentation...Local areaFlexible hours$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...Hourly payPart timeRemote work- ...efficiency of healthcare services, the part‑time Ohio Licensed Utilization Review Nurse will conduct reviews for admissions and transfers,... ...NLN accredited School of Nursing Minimum of 3 years of acute care nursing experience Current RN license in the state of hire...Part timeRemote work
$100k - $110k
...QUALIFIED Healthcare Professionals accepted) Registered Nurse - Job #3191 - Registered Nurse MDS Assessor - New York,... ...salary and the opportunity to play a vital role in optimizing care and regulatory compliance in a long-term care environment. Position Highlights: Employment...Full time- ...Under supervision, provides professional nursing care within their designated acute care facility... ...restorative of life and well‑being, while ensuring optimal utilization of resources, service delivery, safe patient care, and compliance with all applicable local, state, federal...Local area
$40 - $43 per hour
Description Registered Nurse (RN) Wound Program Director (certification... ...-time considered). A Wound Care Registered Nurse plays a... ...treatment, and education to promote optimal wound healing and resident... ...wound care management and ensures compliance with regulatory standards....Hourly payWeekly payFull timePart timeMonday to FridayFlexible hours- ...with accreditation and compliance standards. Provides one... ...to develop a personal care plans, and support of individuals... ...achieve and maintain optimal health. Job Duties... ...and accountability. Utilizes clinical knowledge and... ...- Licensed Registered Nurse_PA - State of Pennsylvania...Daily paidFull timeTemporary workPart timeFlexible hoursShift work
- ...Director of Nursing – Home Infusion Albany, New York... ...strategy, and regulatory compliance. Overview: Provide... ...growth, and exceptional care. Recruit, develop, and... ...demand, and resource utilization to proactively address... ...Collaborate with leadership to optimize workflows, strengthen...
$118.7k - $131.89k
...and evaluates the health care delivery program in compliance with regulations and accreditation... ...are met. They review and manage inmate health cases... ...hospitalizations, and referrals to optimize care and control costs.... ...Bachelor’s Degree in Nursing Experience Delivery and...$90k - $151k
...in the provision of chronic hemodialysis care and treatment. Provides day to day direction... ..., effective delivery of patient care in compliance with standards outlined in the facility... ...of patient information. Coordinate Charge Nurse duties with Staff RNs acting in the...Temporary workShift work- ...Job Title Provides professional nursing direct patient care in compliance with professional practice and unit standards. Promotes a collaborative,... ...the care of patients in a defined care delivery model, utilizing the nursing process, which includes assessment, planning...Full timeTemporary workNight shift
$87k
...Overview The ACCS Team Nurse (Registered Nurse) promotes the full... ...access to and management of health care for PS in conjunction with... ...Administration Program (MAP) compliance for Team and associated GLEs and... ...(PCA) services, obtain and review all 485s from VNA services and...InternshipWork at officeRelocation package$40 - $42 per hour
...Registered Nurse In Flight, Inc. Hudson, New York, United States... ...policies and procedures and in compliance with all regulatory agencies.... ...follow up. Provide person-centered care. Communicate critical findings... ...Plan of Nursing Services, review and update and train staff annually...Hourly payImmediate startFlexible hours
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