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- ...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
$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- 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
$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...
- ...RN- Utilization Review Nurse Inpatient *Hybrid* Must reside within the New York Tri-State Area... ...WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE! VillageCare... ...complete and accurate documentation in compliance with VCMAX policies and procedures....Full timeLocal areaWork from home
- ...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...
- Martin's Point Health Care Inc. is looking for a Utilization Review Nurse in New York. This role requires a strong background in clinical nursing and utilization management to ensure quality, cost‑efficient medical outcomes. Responsibilities include reviewing prior authorization...Remote job
- 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
- Position Summary The Utilization Review Nurse is responsible for ensuring the receipt of high quality... ...discharge plans, coordinates transitions of care, makes referrals for care management... ...for billing, coding, and other compliance or reimbursement related issues. Collaborate...Remote jobWork at officeFlexible hours
- ...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...
$48.54 - $80.92 per hour
...Infusion Nurse II An Infusion Nurse II is a licensed... ...direct patient care to patients in the home... ...safety with continuity and compliance under a physician's... ...timelines for billing optimization. Completes all... ...scheduling, performance reviews, discipline, etc.)...Part timeLocal areaFlexible hoursWeekend work$30.64 - $45.8 per hour
The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in‑patient admissions and out‑patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals...Hourly payMinimum wageFull timeWork at officeLocal areaRemote workFlexible hours- ...designated clinical sites, ensuring high-quality patient care, regulatory compliance, and optimal staff performance. This role serves as a liaison... ...retention efforts. · Provide mentorship and coaching to nursing staff. · Facilitate daily huddles, staff meetings, and...
- IntelliResume is seeking a Clinical Coordinator RN PreSurgical Optimization to work with high-risk patient populations at NYU Langone... ...before surgery. Candidates should have a Bachelor’s degree in nursing and 3-5 years of relevant nursing experience. Benefits include...
$2,340 per week
...Registered Nurse (RN) | Stepdown Location: Brooklyn, NY Agency: FlexCare Pay... ...to provide the highest level of patient care possible. For clinicians, we open... ...success, from payroll to clinical support to compliance. FlexCare pushes beyond...Full timeContract workImmediate startShift workNight shift- ...Registered Nurse (RN) | Telemetry Location: Jersey City, NJ Agency: Concentric... ...Short Term Disability ~ Voluntary Pet Care Insurance Concentric is dedicated... ...program. JCAHO certification acknowledges compliance with the Joint Commission’s national set...Weekly payFull timeContract workTemporary workImmediate start
- ...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... ...patient information. Coordinate Charge Nurse duties with Staff RNs acting in the...Full timeTemporary workShift work
$40 - $50 per hour
...currently seeking a highly qualified registered nurse to join our growing healthcare team in... ..., you will provide direct nursing care to patients and tend to their needs. You... ...committed to best practices, knowledgeable of compliance requirements, and able to perform well...Hourly payDaily paidFull timePart timeFlexible hoursShift workNight shiftDay shiftAfternoon shift$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...$140.4k - $159.27k
...Clinical Coordinator RN PreSurgical Optimization Home (Critical Care Experience Required) at NYU Langone Health... ...-related pre-operative referrals. Review comprehensive risk assessments for... ...Requirements Education: Bachelor's degree in nursing required Experience: 3-5 years of...Full timeDay shift- Santa Barbara Cottage Hospital is hiring a Utilization Review Nurse for a remote position. The role involves gathering clinical information, certifying medical necessity, and making decisions on treatment certifications. Ideal candidates will have a strong nursing background...Remote job
$36 per hour
...the professions of Registered Nurses, Licensed Practical Nurses,... ...providing quality service in compliance with the highest standards of... ...make informed decisions and optimize the full gamut of back-end operations... ...foundation of exceptional care. Citadel believes healthcare...Hourly payDaily paidFull timeTemporary workPart timeImmediate startShift work$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- ...York is seeking a Specialty Program Manager to oversee specialty care programs, ensuring operational efficiency and clinical... ...cross-specialty programs, and employing Six Sigma methodologies to optimize care delivery. Comprehensive benefits package offered including...Flexible hours
$58 per hour
...Overview - Part-Time Registered Nurse (Residential Services)... ...our client, supporting clinical care, case management, and nursing... ...documentation, and maintaining compliance with clinical and regulatory standards... ...and Compliance: Review clinical records to ensure accuracy...Temporary workPart timeWork at office3 days per week
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