Concurrent Review Nurse - Utilization Mgmt (Bilingual)
Leon Medical Center
Leon Medical Center in New York is seeking a Concurrent Review Nurse to ensure medically necessary, high-quality, and cost-effective care through inpatient and outpatient care reviews, leveraging CMS guidelines and established medical policies. You will lead clinical review processes, coordinate with providers, and document determinations for precertification, approvals, and denials, while supporting discharge planning and care transitions. #J-18808-Ljbffr Leon Medical Center
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Concurrent Review Nurse - Utilization Mgmt (Bilingual) in Florida, NY vacancy
- ...supervision of the Director of Health Services, the Concurrent Review Nurse is responsible for ensuring the delivery of... ...two (2) years of experience in clinical review or utilization management Language Skills Bilingual in English and Spanish (required) #J-18808-...Bilingual
- Job Description Daily Responsibilities of Registered Nurse Concurrent Review; Telephonically review inpatient admissions to assure appropriate level of care and medical necessity Review admissions through telephonic review to ensure medical necessity and appropriate level...SuggestedWork at officeMonday to Friday
- ...Summary We are seeking a highly motivated and experienced Utilization Review Nurse to join our team. The Utilization Review Nurse will play a... ...Advisor review. e) Collaborate with insurance companies on concurrently denied and high risk for denial cases. Documentation...SuggestedWork experience placement
$122.91k - $188.02k
...Healthfirst is seeking a Medical Peer Reviewer in the Town of Florida, NY, to consult on medical necessity within utilization management. This vital role involves reviewing authorization requests and ensuring compliance with Healthfirst's regulations. The ideal candidate...SuggestedHealth First
Florida, NY1 day ago- ...services company is seeking a Clinical Care Reviewer based in Doral, FL. The role requires a... ...licensure and a minimum of 3 years of nursing experience, preferably in critical care... ...Candidates should have experience with Utilization Review, familiarity with Interqual Criterion...Suggested
- ...guidelines to emergent/urgent and continued stay reviews. Perform onsite review of emergent/... ...member care Educate providers on utilization and medical management processes Provide... ...RN, BSN preferred. 2+ years of clinical nursing experience in an acute care setting 1+...Shift work
- ...healthcare organization is seeking an experienced Registered Nurse (RN) in Florida. The role involves evaluating patient medical... ...management guidelines. Candidates should have strong experience in utilization review or case management and excellent communication skills. This...
- ...leading healthcare staffing firm is seeking a qualified clinical nurse for a utilization management role. Candidates should possess at least 2 years... ...healthcare staff to ensure quality care and involves reviewing medical necessity. Applicants can reach out to the recruitment...
- Jobtailor is seeking a licensed registered nurse to perform preauthorization reviews for diagnostic imaging, focusing on medical necessity and treatment... ...UM guidelines, ICD-10/CPT-4 coding, and experience in utilization or quality management or call centers. On-site work is...
- Health Business Solutions LLC seeks an experienced Utilization Review Nurse in New York to provide clinical guidance, drive appropriate level of care, and support revenue cycle efficiency. You will conduct medical record assessments, coordinate care with interdisciplinary...
- A leading healthcare staffing firm is seeking a Registered Nurse for Concurrent Review in Florida. The role involves telephonic review of inpatient admissions to ensure appropriate medical necessity and care levels. Candidates must have an active RN license in Florida and...Full timeWork at officeMonday to Friday
- ...patient care, providing skilled nursing care and oversight in... ...Florida Nurse Practice Act, utilizing the nursing process of assessment... ...patient and family; participate in review and revision of the care plan... ...field. English proficiency; bilingual preferred. Excellent...BilingualNight shift
- TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews, assisting...Remote job
- IHCS seeks a Utilization Management Nurse to ensure home health services are delivered with quality, cost efficiency, and compliance. You will review patient treatment files, perform concurrent reviews, and coordinate care with a multidisciplinary team. State licensure...
- ...interested. Title: Clinical Care Reviewer Location: Doral, FL Duration:... ...FL RN licensure Registered Nurse graduated from an accredited... ...g. ER, ICU) Experience with Utilization Review and/or Prior... ...UM role (Prior Authorization, Concurrent Review). Submits appropriate...
- ...program What Will You Be Doing As a Utilization Management Nurse, you will ensure that home health care... ...within compliance. By continuously reviewing and auditing patient treatment files... ...extensive home healthcare. Concurrent review of patient’s clinical information...Full timeTemporary work
- Bilingual (English/Spanish) Registered Nurse (RN) - Full-Time & Part-Time Remote Triage | Weekdays & Weekends | CPT... ...and placing outbound calls, while utilizing Schmitt-Thompson telephone triage... ...Monitoring (RPM) programs by reviewing patient vital signs and providing...BilingualRemote jobHourly payFull timePart timeWork at officeWeekend workWeekday work
- ...using the functions of Utilization Resource Management,... ...supplies home health nursing and inpatient/outpatient... ...determine admission & concurrent level of care criteria... ...and concurrent/retro reviews using available third-... ...and courteous manner. Bilingual English/Spanish preferred...BilingualDaily paidWork experience placementFlexible hours
- New Horizons of the Treasure Coast and Okeechobee seeks a Utilization Review Specialist to manage patient accounts requiring authorization. Responsibilities include initiating pre-certification, reviewing EMR for care level criteria, and communicating with insurers to...
$26.41 - $51.49 per hour
Molina Healthcare in California, MO is seeking a Clinical Member Services Reviewer. The role includes assessing clinical service requests, ensuring compliance with regulations, and collaborating with teams for healthcare delivery. The ideal candidate has an active RN license...Hourly pay- Description PRIMARY PURPOSE: To support utilization management, quality improvement, population... ...activities. 2. Utilization Management Review utilization data to identify trends in... ...QUALIFICATIONS: Associate Degree in Nursing required ; Bachelor of Science in Nursing...Work at office
- First Coast Service Options is seeking a Clinical Review Nurse to evaluate medical necessity, coverage, and payment levels for Medicare-related claims. The role applies clinical knowledge to determine the appropriateness of care in line with CMS policies and standards....Remote job
- Molina Healthcare is seeking an RN to support clinical member services review assessment processes in New York. You will verify medical necessity and alignment with guidelines, coordinating care across the continuum to reach desired outcomes. Responsibilities include prior...
- ...compassionate, organized, and patient-focused Nurse Navigator to support patients throughout... ..., and care plans are completed. Review patient records and clinical information... ...outpatient or specialty medical practice. Bilingual abilities are a plus. Physical Requirements...BilingualWork at officeLocal area
PRECISION HEALTHCARE SPECIALISTS LLC
Florida, NY1 day ago - ...putting people first! Position: Licensed Practical / Vocational Nurse (LPN/LVN) with Spanish proficiency. Responsibilities: Provide high... ...clinical outcomes through compassionate and empathetic care. Utilize electronic documentation via tablets in patients' homes, support...BilingualFlexible hoursNight shift
$55.18k - $66.63k
NURSE HOME VISITOR - (Mobile, Baldwin, Escambia, Conecuh Counties) To provide comprehensive... ...Develops therapeutic relationships, utilizes concepts of reflection and motivational... ...written and verbal communication skills. A bilingual candidate who can speak Spanish is a...BilingualWork experience placementFlexible hoursShift workAfternoon shift- ...assessments, interventions and levels of nursing vigilance. The Pre-Op/ PACU RN is... .... Knowledge of specialized equipment. Bilingual (English/Spanish). Minimum one year in... ...disciplines as needed. Participate in quality review and performance improvement projects. Participate...Bilingual
- Jobtailor in New York seeks an experienced nurse (RN/LPN) to lead utilization reviews and support clinicians. You will apply medical policies, mentor staff, and collaborate with leadership on process improvements to enhance health outcomes. The role requires 6+ years of...
- ...patient care, providing skilled nursing care and oversight in... ...Florida Nurse Practice Act, utilizing the nursing process of assessment... ...read, write and speak English. Bilingual preferred. Excellent communication... ...based on competency review, chart audits and direct oversight...BilingualLocal areaNight shift
- ...hospital readmissions, reduce over‑utilization, and improve overall health... ...(within 24‑72 hours), reviewing discharge summaries, medication... ...Education: Degree in Nursing (ASN or BSN), Social Work (BSW... ...coordination/utilization review. Bilingual (English and Spanish) to...BilingualFull timeShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Concurrent Review Nurse - Utilization Mgmt (Bilingual). Be the first to apply!
Related searches
- bilingual warehouse Florida, NY
- bilingual case manager Florida, NY
- bilingual manager Florida, NY
- bilingual school Florida, NY
- bilingual french Florida, NY
- bilingual customer support specialist Florida, NY
- bilingual insurance agent Florida, NY
- bilingual dental assistant Florida, NY
- bilingual part time Florida, NY
- bilingual account manager Florida, NY