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- 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...SuggestedRemote 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...SuggestedHourly payWeekly payLocal areaShift work$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 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...Suggested
- ...Responsibilities Responsible for utilization review work for emergency admissions and continued stay reviews... ...least 3 years clinical experience in acute care setting in emergency room, critical care and/or medical/surgical nursing At least 2 years utilization management...For contractorsWork at officeRemote work
- Currently seeking a Utilization Management RN . Please see... ...PA license or a Nurse Licensure Compact to include... ...medical record review to determine medical necessity... ...patients, and ensure compliance with federal, state,... ...to ensure appropriate care settings. Report utilization...Immediate startRemote workDay shift
- ...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 job
$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- ...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...
- ...seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)... ...medical necessity and appropriateness of care Apply evidence-based criteria to... ...accurately and in a timely manner Maintain compliance with internal and external regulatory standards...Full timeContract workRemote work
- Mass General Brigham Incorporated is seeking a P2P Utilization Review Nurse to join the Central Utilization Management team. You will identify, prepare... ...peer-to-peer discussions, focusing on concurrent level-of-care denials and using InterQual/MCG criteria with thorough...Remote job
- Molina Healthcare is seeking a Remote Medical Review Nurse (LVN/LPN) for PST schedule in the United States. The role involves reviewing documentation... ...to ensure medical necessity and appropriate level of care, with focus on coding accuracy and reimbursement. The candidate...Remote jobShift work
- Integra Partners is seeking a licensed Practical Nurse (LPN/LVN) experienced in managed care UM to perform pre-service and post-service utilization reviews and appeals for DMEPOS, working with our Medical Director in a NCQA-compliant UM program. You will review benefit...Remote job
$50 - $52 per hour
...exclusive features. Title: Registered Nurse - Primary Care Location: Elmhurst, NY (Onsite... ...adjust as necessary. Ensure compliance with all relevant regulations... ...with healthcare providers to optimize patient outcomes. Key Responsibilities Review work and develop plans based...Full timeContract workNight shift$48 - $50 per hour
...culture of curiosity, creativity, and optimism and as we advocate for people with... ...looking to fill a Per-Diem Registered Nurse (RN) position in a Manhattan IRA residence... .... Ensures that delivery of nursing care is conducted in compliance with all federal and state...Hourly payDaily paidLocal areaFlexible hours$45 - $52 per hour
...contouring treatment designed to optimize both comfort and precision,... ...seeking a dynamic Registered Nurse (RN) to join our team,... ...individual with a passion for patient care, dedicated to ensuring a... ...one of our clinics. Ensuring compliance with all health care regulations...Full timeContract workTemporary workFor contractorsFor subcontractorWork at officeLocal areaShift workWeekend work- ...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
- ...Type Bachelor of Science in Nursing (BSN)Employment Full TimeWorking... ...high-quality patient care and operational excellence.Oversee... ...oriented culture while maintaining compliance with scope of practice... ...collaboration across departments to optimize patient care.Support surgical...
$1,887 per week
...Registered Nurse (RN) | Telemetry Location: New York, NY Agency: FlexCare... ...to provide the highest level of patient care possible. For clinicians, we open... ...success, from payroll to clinical support to compliance. FlexCare pushes beyond healthcare...Full timeContract workLocal areaImmediate startShift workNight shift$2,431 per week
...Registered Nurse (RN) | Outpatient Clinic Location: New York, NY Agency: FlexCare... ...to provide the highest level of patient care possible. For clinicians, we open... ..., from payroll to clinical support to compliance. FlexCare pushes beyond healthcare...Full timeContract workImmediate startShift work- IntusCare is seeking a Utilization Management (UM) Manager to lead the UM nurse team supporting a PACE program. You will... ...to-end UM delivery, ensure SLA compliance, and apply clinical decision support criteria across cases to optimize care and efficiency. The role blends...Remote job
- LionStone Care in Dublin, OH is seeking an MDS Coordinator - LPN to lead the MDS assessment... ...and collaborate with the care team to optimize care plans and reimbursement where... ...LPN graduates with 2-3 years of clinical nursing experience, including long-term care, and...
$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...- Provide comprehensive hospice services in compliance with the state Nurse Practice Act Evaluate and assess the... ...and developing the plan of care Prescribe medications or treatments... ...Nursing Licensure Master's Degree ATS Optimization Keywords Hard Skills Health Assessment...
- ...workforce solutions. Our recruiting and HR services include contract and direct hire staffing, Payrolling/EOR, Independent Contractor Compliance, and Managed Services. For almost 30 years, we've helped shape our industry. Today, we continue to research, ask questions,...Contract workFor contractors
$17 - $22 per hour
...monitoring to ensure compliance with protocols, regulations... ...data discrepancies, reviewing adverse events, and... ...problem-solving, process optimization, and continuous... ...science, pre-medicine, nursing, bioengineering, or a... ...- All Levels Clinical Care Coordinator (Remote) -...Contract workTemporary workLocal areaRemote workWork from homeDay shift- # Skilled Nursing Facility Medical Director - Montour... ...excellence in patient care.**Job Summary**The Medical... ...care, regulatory compliance, and adherence to best... ...regulatory bodies, supporting optimal resident outcomes and... ...within the facility.* Review and approve clinical policies...
- ...industries. These include mobile research nursing, patient concierge, medical photography... ...for those patients for on- and off-site care. Ensure the accurate reporting of adverse... ...employees. The Company is committed to compliance with the Americans with Disabilities Act,...Daily paidContract workRemote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Utilization Review Nurse: Optimize Care & Compliance. Be the first to apply!
- remote utilization review nurse New York, NY
- remote utilization review nurse part time New York, NY
- utilization review nurse New York, NY
- athletic compliance New York, NY
- compliance technician New York, NY
- vendor compliance New York, NY
- alcohol compliance New York, NY
- affordable housing compliance New York, NY
- code compliance New York, NY
- entry level regulatory affairs New York, NY


