Nurse (Health Care)
$73.86k - $96.02kBaptist Health Bethesda Hospital
Baptist Health Bethesda Hospital is looking for a Registered Nurse to conduct clinical financial resource utilization reviews. In this role, you will coordinate with healthcare teams to decrease length of stay and avoid denied days while managing a designated patient caseload.
Applicants must have an Associates degree in Nursing and required RN certifications. Strong analytical and communication skills are essential. Competitive salary range is $73,860.80 - $96,019.04 based on experience.
#J-18808-Ljbffr Baptist Health Bethesda Hospital
$73.86k - $96.02k
...reflect our commitment to caring for our people, so they... ...concurrent, retrospective chart review for clinical financial resource utilization. Coordinates with... ...decrease avoidable delays, denial of reimbursement. Specific... ...-leadership role as an RN. However, they are required...SuggestedLocal area$68.13k - $119.52k
...stay medical necessity reviews. Maintain thorough... ...concurrent and pre-bill denials to prevent loss of reimbursement.... ...the multidisciplinary care team regarding patient... ...for in-house patients, utilizing daily commercial... ...Certifications: Registered Nurse (RN) [Required] Basic...SuggestedFull timeWork experience placementLocal areaShift work- Itlearn360 is seeking a dedicated Utilization Management professional based... ...licensure as either an LPN or RN and a minimum of 2 years of... ...Management. Responsibilities include reviewing patient clinical information,... ...focused on teamwork and patient care. #J-18808-Ljbffr Itlearn360SuggestedFull time
$26.41 - $51.49 per hour
...California, MO is seeking a Clinical Member Services Reviewer. The role includes assessing clinical service... ...delivery. The ideal candidate has an active RN license and at least 2 years of experience in hospital or managed care settings. Competitive pay is offered, ranging...SuggestedHourly pay- TurningPoint Healthcare Solutions is seeking a Utilization Review Nurse to join their team in a fully... ...Practitioner (LPN) or Registered Nurse (RN) with strong critical thinking skills... ...quality improvement, and resolving patient care issues with providers. Candidates should...SuggestedRemote job
- ...healthcare services company is seeking a Clinical Care Reviewer based in Doral, FL. The role requires a current FL RN licensure and a minimum of 3 years of nursing... ...or ICU. Candidates should have experience with Utilization Review, familiarity with Interqual Criterion,...
$80k - $90k
...Responsibilities*** Performs clinical reviews on medical records to... ...-time intervention, preventing an accumulation of... ....* Experience with utilization management systems or... ...tools such as Millimen Care Guidelines (MCG) or InterQual... ...** Active unrestricted RN license #J-18808-Ljbffr...Remote workFlexible hours$26.41 - $51.49 per hour
...for clinical member services review assessment processes. Responsible... ...integrated delivery of care across the continuum. Contributes... ...Molina care model. Adheres to utilization management (UM) policies and procedures... ...experience. Registered Nurse (RN). License must be active and...Hourly payWork experience placementWork at officeRemote work- ...staffing firm is seeking a Registered Nurse for Concurrent Review in Florida. The role involves telephonic review of... ...to ensure appropriate medical necessity and care levels. Candidates must have an active RN license in Florida and 2+ years of clinical experience...Full timeWork at officeMonday to Friday
$29.1 - $62.32 per hour
...Aetna Resources, LLC is seeking a Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) to support healthcare quality and care coordination. This full-time remote... ...experience, with responsibilities including reviewing clinical cases and collaborating on...Remote jobHourly payFull time$25k
Become a part of our caring community. The Clinical Care Nurse (RN) is a clinic-based nursing... ...TOC), reduce avoidable ED utilization, and drive Medicare... ...and avoidable readmission prevention for discharged inpatient... ...adherence. Identify and elevate barriers, collaborating...Temporary workApprenticeshipWork at officeMonday to Friday- ...providing the highest quality in‑home care services that improve and... ...Will You Be Doing Concurrent review of patient’s clinical... ...Provide updates to Manager of Utilization Management for review What Will... ...State licensure as a LPN or RN Minimum 2 years of prior experience...Full timeTemporary work
$71.1k - $97.8k
...Job Summary The Utilization Management Nurse 2 uses clinical nursing skills... ...parties to facilitate optimal care.• Make decisions regarding... ...Qualifications Licensed Registered Nurse (RN) with at least 3 years of... ...in utilization management/review or prior authorizations....Local areaRemote workMonday to FridayShift workWeekday work- Broughton Group is looking for a motivated Utilization Review Nurse to join their team in New York, supporting national health plans. The role involves performing clinical reviews to determine medical necessity, working independently, and meeting deadlines. The ideal candidate...
$31.53 - $52.24 per hour
...community resource needs. Reviews patient history,... ...physician. Implements care plans through direct patient... ...skilled nursing care, preventative rehabilitative... ...and best practice visit utilization. Other duties as assigned... ...Registered Nurse (RN) [Required] Driver's License...Full timeWork experience placementLocal areaShift work- ...Healthcare Solutions is hiring a Supervisor, Clinical Review Nurse in New York. This full-time role involves overseeing Utilization Management activities and leading a clinical team. Candidates should possess an active RN license, a minimum of five years of clinical...Full time
- UF Health in New York, Town of Florida, is seeking a qualified Registered Nurse to provide outstanding patient care. The role involves utilizing the nursing process to assess and implement care plans for patients under the direction of the unit director. Candidates must...
- Wound Care Registered Nurse (RN) - $5,000 Sign on Bonus Valencia Hills Health and Rehabilitation Center... ...operation of the facility Infection Prevention/Control Program and supports... ..., genitourinary, and dermal systems. Utilizes current wound management theory when...Daily paidRelocation packageShift workNight shiftWeekend work
- Gulf Shore Care Center is looking for a Wound Care Nurse in the Town of Florida, NY. The... .... Candidates should have a current RN or LPN License in Florida and wound care... ...certification or experience. Understanding infection prevention protocols is essential. This position...Weekend work
$40 per hour
...Nurse Reviewer PT (20‐30 hours week) – Remote Work Environment Non‐Exempt... ...and regulations. The RN will work closely with the Team... ...with established standards of care and applicable policies Manage... ...claims against industry standards, utilizing research of relevant ICD‐10,...Contract workWork at officeLocal areaImmediate startRemote work- * Active RN license* CPR certification* Clinical... ...love for patient-centered care, especially in a home... ...Initiates appropriate preventive and rehabilitative nursing... ...and procedures utilizing community resources as... ...clinical record/utilization review of medical records and...Weekly payDaily paidImmediate startFlexible hoursNight shiftWeekend workWeekday work
$36.89 - $61.49 per hour
...of your career. Option Care Health, Inc. is the... ...work compassionately to elevate standards of care for patients... ...and educates on prevention of line infection and routine... ..., performance reviews, discipline, etc.) No... ...Active and unrestricted RN license in the state of...Part timeLocal areaFlexible hours- Job Description - RN- NICU, Coral Springs (Full Time... ...professional nursing care in accordance with... ...bathing, and repositioning. Reviews patient admission... ...hospital policies, conducts prevention rounding, & follows up... ...and interpret data and utilize the information to make...Full timeFlexible hoursShift workNight shift
- A caring home healthcare agency is seeking an experienced Registered Nurse (RN) to join their team in Florida. The RN will be pivotal in conducting in-home assessments and... ...both office and fieldwork, contributing to elevated quality of life for seniors. This position offers...Full timePart timeWork at officeFlexible hours
- ...renders professional nursing care in accordance with... ..., and repositioning. Reviews patient admission history... ...policies, conducts prevention rounding, & follows up... ...school (AD in Nursing, RN Diploma, or BSN); or if... ...and interpret data and utilize the information to make...Daily paidFlexible hoursShift workNight shift
- ...Responsibilities of Registered Nurse Concurrent Review; Telephonically review inpatient admissions to assure appropriate level of care and medical necessity Review admissions... ...Registered Nurse Concurrent Review; Current, active RN in the state of Florida 2+ years of...Work at officeMonday to Friday
$71.1k - $97.8k
A leading health insurance company is seeking a Utilization Management Registered Nurse to utilize clinical nursing... ...position requires clinical experience and a Compact RN license. Responsibilities include making care determinations, excellent communication with providers...Remote job$71.1k - $97.8k
Job Summary The Utilization Management Registered Nurse uses clinical nursing... ...This team manages post-acute care services, including Skilled... ...a Compact Registered Nurse (RN) license in your state of residence... ...management/utilization review for a health plan or acute care...Bi-weekly payTemporary workRemote work- RN - Hialeah Urgent Care Center (Full Time, Days) - 301442 Job Summary Responsible... ...and delivery of care utilizing nursing processes: assessment... ...with patients and families to review plan of care and solicits... ...utilizing SBAR) and infection prevention measures. Ensures safe/...Full time
- Infusion RN - Part Time - Volusia County page is... ...your career.** Option Care Health, Inc. is the largest... ...compassionately to elevate standards of care for patients... ...and educates on prevention of line infection and routine... ..., performance reviews, discipline, etc.)No -...Part timeLocal area
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