Utilization Review Registered Nurse
$89.54k - $136.47kSentara Health
Work Shift Sentara Health is hiring a Remote Utilization Review Registered Nurse. As an integrated care manager, specializing in Utilization review, the registered nurse will be responsible for utilization review services within the scope of licensure. Conducts primary function of prior authorization for inpatient and outpatient reviews both initial and concurrent continued stay review. Reviews for appropriate treatment setting to ensure compliance with applicable criteria, and regulatory requirements. N-3 Years RN- Diploma (required)
- Registered Nurse in the State of Virginia (required)
- For Integrated Care Management departments, specialty certification required within one year of eligibility (ACM, CCM, CCCTM, CMAC or CGMT-BC). 3 years of nursing experience in acute care (required)
- 3 years Case Management experience (preferred)
- Proficient in basic computer skills
- Adoption, Fertility and Surrogacy Reimbursement up to $10,000
- Emergency Backup Care
- Long-Term, Short-Term Disability, and Critical Illness plans
- Life Insurance
- Legal Resources Plan
- Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
$89.54k - $136.47k
City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health is hiring a Remote Utilization Review Registered Nurse. Candidates must reside in the State of Virginia. As an integrated care manager, specializing in Utilization review, the registered nurse...SuggestedFull timeTemporary workRemote workShift work- ...”Rocky Mountain Care - The Lodge/Heber City is seeking amazing NURSES to join our team in our beautiful facility!We pay shift differentials... ...A current, unencumbered, active license to practice as an (RN) Registered Nurse or Licensed Practical Nurse (LPN) in Utah.Demonstrate...SuggestedFull timeShift workNight shiftWeekend work
$35.22 - $53.29 per hour
...Registered Nurse (RN)The Registered Nurse (RN) is a licensed professional caregiver who assumes... ...evaluating care of patients. The staff RN utilizes the nursing process by use of... ...patient response to interventions through review of achievement of goals, clinical outcomes...SuggestedHourly payFull timeWork experience placementWeekend work$35.22 - $53.29 per hour
...Registered Nurse (RN) The Registered Nurse (RN) is a professional caregiver who assumes responsibility... ...the care of patients. The staff RN utilizes the nursing process by use of... ...patient response to interventions through review of achievement of goals, clinical outcomes...SuggestedHourly payFull timeShift workNight shift- Provide ambulatory orthopedic nursing care by assessing patients, developing and coordinating individualized care plans, implementing protocols and procedures, and evaluating patient outcomes. Collaborate with physicians and the care team, support patient education and...Suggested
- Provide professional nursing care to labor and delivery patients by assessing needs, developing and implementing individualized care plans, coordinating with interdisciplinary teams, and evaluating clinical outcomes. Support patient education, documentation, and safe, ethical...
- Intermountain Health seeks a Registered Nurse for our Emergency Department to deliver high-quality, compassionate care in a fast-paced, team-based setting. The RN performs rapid triage, assessment, and evidence-based interventions for diverse, high-acuity patients while...
- ...Rocky Mountain Care - The Lodge in Heber City, UT, is seeking dedicated nurses (RN/LPN) to join our team. You will provide direct nursing care to residents, develop care plans, and supervise CNAs to ensure quality outcomes. We offer shift differentials for NOC and...Full timeShift workNight shiftWeekend work
- WSi Healthcare Personnel seeks a Registered Nurse to deliver high-quality patient care across partner hospitals and clinics in Colorado. In this staffing role, you’ll perform assessments, administer medications, and support treatment plans while quickly adapting to diverse...Full time
- ...Clinical Expanded Role provides specialty clinical expertise, coordinates and evaluates projects, supports evidence-based care standards, and mentors nursing staff. The role collaborates with patients and healthcare teams to coordinate care and improve clinical practice.
$35.22 - $53.29 per hour
...Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility... ...the care of patients. The staff RN utilizes the nursing process by use of technology... ...patient response to interventions through review of achievement of goals, clinical...Hourly payFull timeRemote workShift workNight shift- ...Rocky Mountain Care - The Lodge/Heber City is seeking amazing NURSES - RNs & LPNs to join our team in our beautiful facility! We have... ...A current, unencumbered, active license to practice as an Registered Nurse (RN) or Licensed Practical Nurse (LPN) in Utah. Demonstrate...Full timeAll shiftsShift workNight shiftWeekend work
- ...Intermountain Health in Heber City is seeking a Registered Nurse (RN) to provide ambulatory care in the Heber Valley Clinic. You will assess, plan, implement and evaluate patient care, collaborating with physicians and the health team to ensure safe, effective treatment...Full timeShift work
- ...Remote Care Management Nurse (Future Opportunities) Work from home... ...care experience.Are you a Registered Nurse looking to transition out... ...and into a role that still utilizes your clinical expertise, but... ..., auditing, or retrospective reviewS. state or territory that allows...Work at officeImmediate startRemote workWork from homeFlexible hours
$33.11 - $52.8 per hour
...patient’s signs and symptoms utilizing established triage protocols... ...Participates in weekly huddles to review Key Performance Indicators (... ...symptoms/complaints, nursing assessment, advice provided and... ...Certification(s): ~ State of Colorado Registered Nurse or valid compact state...Hourly payTemporary workWork at officeImmediate startRemote workShift work- ...Teamwork, Integrity and Excellence every day. We are seeking a nurse to join our team in the Salt Lake and Tooele areas. In this role... ...Areas Schedule: Days / Swings Requirements Valid Practical or Registered Nursing License within State of Utah Active BLS certification 1...Weekly payRelocation packageNight shift
- ...Intermountain Health Heber Valley Hospital in Heber City, Utah is seeking a Registered Nurse (RN) for a full-time night shift. This 36-hour-per-week role in the Medical Surgical department requires a current RN license, BLS, and a BSN pathway within four years of hire...Full timeNight shift
- ...CorVel Corporation is hiring a registered nurse for a Medical Case Manager role in Utah. This remote position requires residing in Utah with heavy local travel to manage a caseload of workers’ compensation cases. You will perform in-person and telephonic case management...Local areaRemote work
- ...Arkansas Blue Cross Blue Shield is seeking an experienced Utilization Management Nurse to perform clinical reviews for prior approvals, network exceptions, and benefit inquiries. You will evaluate inpatient and outpatient services for medical necessity using evidence-...Remote work
- ...Utah, and Washington. You will assess, plan, coordinate and monitor member care to improve outcomes and reduce costs. Requires nursing or related degree plus 3 years of case management experience; licensure; strong communication; familiarity with health insurance trends...Remote work
- ...Highmark Health (Highmark Inc.) is seeking a remote Care Manager to implement utilization management strategies, review care appropriateness, and identify opportunities for Health Coach interventions. The role requires weekend availability (Saturday and Sunday) and three...Remote workWeekend workWeekday work
$37.2 - $50.4 per hour
...Utilization Management Nurse Work from home within Oregon, Washington, Idaho or Utah Preference will... ...concurrent and retrospective review) to best meet the member’s specific healthcare... ...preferred for behavioral health); or Registered nurse (RN) license (must have a...Full timeWork at officeImmediate startRemote workWork from homeFlexible hours$175k
...Physiatry (PM&R) Nurse Practitioner / Physician Assistant Iconic Care Support Services Heber City, Utah, United States About this position This role requires relocation to Redding, CA to be onsite and Skilled Nursing Facilities in the area. Generous relocation...Full timeContract workImmediate startRelocationMonday to FridayFlexible hoursShift workDay shift3 days per week1 day per week$180k - $215k
...hospital practice with the clinical autonomy of private practice. This role is designed for experienced Psychiatric Mental Health Nurse Practitioners (PMHNPs) who want: Predictable, W-2 compensation and benefits Control over their schedule, session structure,...Full timePart timePrivate practiceImmediate startRemote work- ...of the client with health care professionals (e.g. PCP, etc.) Utilize evidence-based practices, such as Motivational Interviewing, Harm... ...& qualifications ~ Active, unrestricted Licensed Vocational Nurse (LVN) license in California required ~ Willing and able to work...Full timeLocal areaImmediate startRemote workMonday to FridayShift workWeekend workAfternoon shift
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