RN Utilization Review Specialist — Optimize Care & Coverage
University Medical Center, Inc.
The University Medical Center, Inc. in Cincinnati is seeking a Utilization Review RN to manage utilization review functions. You will perform evaluations regarding patient admissions and insurance compliance, communicating effectively with physicians and care teams. This role requires at least two years of RN experience, and it offers opportunities for professional development while ensuring high-quality patient care and compliance with healthcare standards. #J-18808-Ljbffr University Medical Center, Inc.
- ...Job Description Summary: Position Summary and Purpose The Utilization Review RN performs activities which support the Utilization... ...review. They process payor denials and retro reviews, promote optimal health care outcomes in accordance with the policies, procedures, applicable...SuggestedWork at officeShift work
- ...UR Specialist Shift: M-Fr 8-5 This is not a remote... ...and deliver holistic care to those in need of behavioral... ...Position Summary: The Utilization Review Specialist is... ...the patient to secure coverage for needed services.... ...preferred. License : LPN, RN, LSW, LPC, LCDC or...SuggestedWork at officeFlexible hoursShift work
$62k - $85k
...set new standards of care. The Distribution Specialist (Distribution... ...with Distribution Optimization teams to surface recurring... .... ~ Review performance regularly... ...training, and shift coverage aligned with volume... ...~ Monitor labor utilization, overtime, and productivity...SuggestedTemporary workShift workWeekend workAfternoon shift- ...clinically integrated eye care. Our national network... ...: RCM Medical Coding Specialist SUMMARY The... ...charge-ticket coding to optimize reimbursement by... ...standards and guidelines. Review medical records and... ...Experience with the utilization of modifiers and other...SuggestedWork at office
- ...phone calls and schedules patient care activities. Facilitate flow of... ...patient and physician scheduling, optimizing patient satisfaction, provider template utilization, and treatment room utilization.... ...Knowledge of health insurance coverage requirements. Basic math skills...SuggestedFull timeWork at office
$29.05 - $67.97 per hour
Job Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical... ...appropriate level of care utilizing MCG/... ...experience. Registered Nurse (RN). License must be... ...Certified Medical Audit Specialist (CMAS), Certified Case...Hourly payWork experience placementWork at office$2,052 per week
...Registered Nurse (RN) | Stepdown Location: Cincinnati... ...in providing care to patients recovering... ...comprehensive medical coverage for you and your family... ...Stepdown - Travel Utilizing critical care nursing... ...healthcare team to provide optimal patient outcomes...Weekly payFull timeImmediate startFlexible hoursShift workNight shiftWeekend work$18 per hour
...Prior Authorization Specialist For over two decades, Riverhills Neuroscience... ...exceptional neuroscience care. Our commitment to excellence... ...with insurance entities, review organizations, and clinical... ...Monitor schedules for insurance coverage changes, oversee specialty...Full timeTemporary workWork at officeRemote workMonday to Friday- Thechristcollege in Cincinnati, Ohio is seeking a Registered Nurse (RN) focused on providing culturally specific patient care and education. The RN will conduct assessments, implement care plans, and evaluate patient outcomes while adhering to organizational policies and...
- ...RN Executive Director Specialist – Hospice Expand Access. Lead Markets. Transform Care. We are seeking a RN Executive Director Specialist – Hospice to join our leadership team. This role acts as the administrator on call and is responsible for the overall operation...Daily paidFull timePart timeLocal area
- ...healthcare provider in Cincinnati seeks a skilled Electrophysiology Lab Registered Nurse. This role involves delivering advanced nursing care during invasive cardiac procedures. Responsibilities include patient assessments, documentation, and collaboration in a...
- ...seeking dedicated nursing professionals to provide individualized care to clients in long-term care settings in Cincinnati, Ohio. This... ...requires a graduate of an accredited nursing program and a valid LPN or RN license. The role includes addressing mental and physical health...
- ...Flex RN – Internal Agency Contract (CVICU... ...our elite Critical Care team as a Flex RN,... ...-clock intensivist coverage and holistic support... ...assessment and peer review. Functions in roles... ..., and councils. Utilizes chain of command appropriately... ...patient based on optimal specific patient...Contract workTemporary workLocal areaFlexible hoursNight shiftWeekend work
- ...Traveler Registered Nurse (RN) A Tier 3 - System... ...to provide patient care promoting and restoring... ...professional nursing practice to optimize goals and outcomes... ...Understanding and utilization of office and clinical... ..., vision, prescription coverage, HSA/FSA options, life...Temporary workWork at officeLocal areaImmediate startFlexible hours
- ...Operational Excellence Lean Specialist - Blue Ash, Ohio... ...indicators for functions being reviewed, evaluates current... ...Lean initiatives Utilize value stream mapping techniques to design optimal information, material,... ...and vision insurance coverage, helping you "be safe,...Temporary workH1b
- ...Metered Utilities Specialist Are you someone who enjoys research and has a keen eye for detail? Do you enjoy math and equations? Are you... ...whose primary function is to manage customer utilities and rate reviews. Essential Functions Core functional knowledge of...Live inWork at officeRemote workRelocationWork visa
$40 - $44 per hour
...treatments and ensure client satisfaction. The role requires an active RN license, effective communication, and a commitment to compliance... ...position promotes personal growth and provides a meaningful impact on clients' lives through quality care. #J-18808-Ljbffr REMOVERY LLCFull time- A healthcare organization in Cincinnati, Ohio is seeking a Telephonic Triage RN. This role involves providing nursing care services through telephonic assessments, ensuring patient needs are met and facilitating communication among care teams. Ideal candidates will have...Immediate start
$30 - $35 per hour
...Bring projects to life behind the scenes. As a Permit Specialist, you'll play a vital role in keeping utility construction projects moving—supporting gas and... ...applying, you acknowledge and agree that your application may be reviewed using AI tools. #J-18808-Ljbffr ActalentContract workTemporary workRemote workWork from homeHome officeFlexible hours$1,915 - $2,033 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Cincinnati, OH Agency: AMN Healthcare... ...and welcoming environment based on optimal patient care. Required Qualifications... ...~Accident and Short-term Disability Coverage ~Free Continuing Education ~Refer...Extra incomePermanent employmentFull timeContract workTemporary workShift workNight shift$1,590 - $1,739 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Fort Thomas, KY Agency: Host Healthcare... ...Satisfaction by MIT Sloan Management Review. No matter if you want to explore... ...premium benefits like Day-1 health coverage, 401K matching, travel reimbursements,...Full timeLocal areaImmediate start$1,720 - $1,873 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Cincinnati, OH Agency: Host Healthcare... ...Satisfaction by MIT Sloan Management Review. No matter if you want to explore... ...premium benefits like Day-1 health coverage, 401K matching, travel reimbursements,...Full timeContract workLocal areaImmediate startShift workNight shift$1,939 - $2,058 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Cincinnati, OH Agency: AMN Healthcare... ...and welcoming environment based on optimal patient care. Required Qualifications... ...~Accident and Short-term Disability Coverage ~Free Continuing Education ~Refer...Extra incomePermanent employmentFull timeContract workTemporary workLocal areaShift workNight shift$1,915 - $2,033 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Cincinnati, OH Agency: AMN Healthcare... ...and welcoming environment based on optimal patient care. Required Qualifications... ...~Accident and Short-term Disability Coverage ~Free Continuing Education ~Refer...Extra incomePermanent employmentFull timeContract workTemporary workLocal areaShift workNight shift$1,590 - $1,739 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Cincinnati, OH Agency: Host Healthcare... ...Satisfaction by MIT Sloan Management Review. No matter if you want to explore... ...premium benefits like Day-1 health coverage, 401K matching, travel reimbursements,...Full timeContract workLocal areaImmediate startShift workNight shift- ...Cash Reconciliation Specialist CommuniCare Health Services is currently... ...Treasury. This position will review unposted cash for facilities... ...medical, dental and vision coverage, from quality benefit... ...accounting preferred ~ Long term care experience preferred Knowledge...Work at officeHome officeFlexible hours
- ...stewardship, leadership and care.The MDS Nurse - RN provides necessary and... ...staff members in order to optimize resident and patient care.*... ...making regarding insurance coverage, cut dates, and MDS schedules... ...with insurance appeals by reviewing documentation coded on MDS...Work at officeLocal area
- ...judgment when performing caring practices - Synthesizes... ...appropriate to support optimal patient outcomes.... ...inquiry & performance review to improve practice - Improves... ...through research utilization and experiential learning... ...required. Active Ohio RN License. May be required...
$70k - $80k
...Design Benefits, we are a team built with CARE - Commitment, Accountability, Respect &... ...Manage the entire RFP process, including reviewing materials, obtaining competitive information... ...negotiation. Operational Efficiency: Utilize Salesforce for data tracking, task assignment...Full timeWork at office$2,052 per week
...Registered Nurse (RN) | Stepdown Location: Cincinnati, OH... ...This role involves providing care to a diverse group of patients... ...insurance - comprehensive medical coverage for you and your family... ...- Stepdown - Travel Utilize specialized knowledge and skills...Weekly payFull timeImmediate startFlexible hoursShift workNight shift
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