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Must have 2 years working in a hospital and 2 years of utilization review (UR) experience in a hospital or insurance company. Uses clinical and analytical skills to review and interpret diagnostic test results to determine appropriateness of patient's level of care.
$68,224 - $104,811.2 a year depends on experienceFull-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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The utilization review nurse manages all activities related to the monitoring, interpreting, and appealing of concurrent clinical denials received from third-party payers and ensures accuracy in patient billing.
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Three to five years of clinical experience as a Registered Nurse, including at least two years performing utilization review, charge audit, case management or similar functions in an acute care or specialty hospital.
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Keywords: Registered Nurse, RN, DON, Director of Nursing, don#inddelaware#ZR. Ensures nursing records are correctly maintainedParticipates in Pharmacy, Therapeutic, and Strategic Initiatives, Patient Safety/Sentinel Event Committee, Performance Improvement, Electronic Medical Records (EMR), Utilization Management and other process improvement committees/initiatives as directed or assignedSupports Company Initiatives and the application of best practices in clinical settings.
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Knowledge of insurance, utilization review, scheduling requirements and support of front desk responsibilities. Pediatric Advanced Life Support (PALS) - American Heart Association; California Registered Nurse (RN) - CA Board of Registered Nursing; AHA Basic Life Support for Healthcare Professional (AHA BLS Healthcare) - American Heart Association; Bachelor's Degree in Nursing; Neonatal Resuscitation Program (NRP) - Various-Employee provides certificate.
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Utilization review and discharge planning experience preferred. The RN Case Manager will be responsible for all aspects of Case Management for Inpatients to determine appropriateness of continued stay, care planning, utilization management and discharge planning.
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Registered Nurse - Utilization Review TRS Healthcare is seeking a Registered Nurse who is licensed to work in MD, and has Utilization Review experience. 1 year of recent experience specializing in Utilization Review.
$2,106.84 a weekExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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3-5 years clinical nursing experience, with 1-3 years Managed Care Experience in the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific program experience as needed or equivalent experience (such as specialties in: surgical, Ob/Gyn, home health, pharmacy, etc.
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Job Name: Case Mgr/Discharge Planner/Utilization Review. Medninjas is seeking a travel nurse RN Case Management for a travel nursing job in Meeker, Colorado. Medninjas is seeking a travel nurse RN Case Management for a travel nursing job in Meeker, Colorado.
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Participating in clinical leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review, and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee.
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Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Savannah, Georgia. Posted job title: Case Management (Utilization Review.
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In place of a Bachelor's in Nursing, an Associate Degree in Nursing (RN) is acceptable with an accompanying 10 years experience in Case Management, Utilization Review, or Clinical Documentation Improvement.
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The Department of Care Management at SUNY Downstate Health Sciences University is seeking a full-time Utilization Review Nurse. Prior hospital and/or community-based Care Management and Utilization Review experience.
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RN - Case Manager/Utilization Review/CDI - needed for 13 week full time contract starting 5/13/24. Minimum of 1.5 years of recent Case Managment/Utilization Review experience in a Hospital with 450 beds.
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Registered Nurse, LPN or Master's level Social Worker with experience in Utilization Management, preferred. River Point Behavioral Health, a subsidiary of UHS, is an 84-bed treatment facility, conveniently located in beautiful central Jacksonville, FL that specializes in the successful treatment of substance abuse and mental health issues for youth, adults and seniors.
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