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The Utilization Review Specialist manages daily operations, which include supervising the staff performing benefit enrollments and utilization management activities. The Utilization Review Specialist participates in department development and unit performance improvement.
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As a Utilization Review Nurse/Integrated Care Manager RN with Sentara, you work together intensely with the patients, families, and members of the medical team to provide patients with the resources they need and help prevent them from being readmitted to the hospital.
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Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on established criteria and critical thinking.
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Focus Staff is seeking a Travel Utilization Review RN Registered Nurse to review and audit behind the scenes to maximize the quality and cost efficiency of health care services.
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During this individual supervision a chart review should be completed using the updated Utilization Review sheet with particular attention paid to whether or not a PGP exists to cover the time period since the last CBH review.
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Under the supervision of the Utilization Review Manager, this position is responsible for ensuring the delivery of outstanding customer service in the process of obtaining pre-certification approvals from insurance companies (for both inpatients and outpatients), identifying insurance and/or patient responsibility, insurance verification, admission notifications, identifying approved days, follow up required, and providing financial counseling when appropriate.
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The RN Care Coordinator consistently conducts the utilization review process and the discharge planning process as required by hospital policies standards of practice and Federal and State regulations.
$46.96 - $68.1 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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A.G. Rhodes is currently hiring for an RN MDS Director for our Wesley Woods community, and we would love the opportunity to work with you. The RN MDS Director position is Full-time Monday through Friday, dayshift hours.
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Focus Staff is seeking a traveling OR RN to work as an Operating room nurse (or perioperative nurse) to assist surgeons during operations and keep the operating room sterile at all times.
$1,896.34 - $1,952.39 a weekTemporaryExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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VNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job in Hoboken, New Jersey. Posted job title: Rn Utilization Review, Clinical.
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The Case Management process facilitates communication and care coordination along a continuum through effective transitional care management and utilization management. 2 years of experience in Case Management (Care Coordination or Utilization Management) or successful completion of the Transitions in Practice (TIP) program for Care Manager.
$52.46 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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ScionHealth - Kindred Cornerstone & Solara Hospitals is seeking a Registered Nurse (RN) Case Management Director for a nursing job in Hawthorne, California. Healthcare professional licensure required as Registered Nurse, Licensed Clinical Social Worker (LCSW),or Licensed Social Worker (LSW), as required by state.
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The Utilization Management Nurse III is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services.
$33.3 - $44.49 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Focus Staff is seeking a travel nurse RN OR - Operating Room for a travel nursing job in Johnson City, Tennessee. Posted job title: Travel OR RN - Operating Room Registered Nurse.
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Focus Staff is seeking a travel nurse RN OR - Operating Room for a travel nursing job in Matthews, North Carolina. Travel OR RN - Operating Room RN, Part-Time, Contract, Travel, Temporary, 13 Weeks, Temp. OR Circulate, Scrub Nurse Tier2.
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hiring is currently utilization review rn jobs Title: travel rn nurse registered Company: Medical Solutions in AK, France
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