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Position is 100% a Utilization Management/Review role. Utilization review experience. Registered Nurse (RN) or Masters-level Behavioral Health Professional (LPC, LMFT, LCSW, LCPC, RPsy) with current license to practice at the independent practice level.
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As a Nurse Liaison you will be an expert in resource management, a master of utilization review and a compassionate partner for patients and their support network. You are an expert in Utilization Management and have knowledge of URAC & NCQA standards.
$110,000 a yearFull-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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We are seeking a dedicated Travel RN specializing in Utilization Review to join our team. This role integrates and coordinates various aspects of service delivery, care facilitation, pay or authorizations, service access, discharge and post-discharge activities, and utilization review.
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Communicates contractual requirements to medical groups, IPAs, and contract management firms, corporate headquarters including but not limited to utilization management, quality review, clinical, and non-clinical quality improvement.
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MUST HAVE UM experience, inpatient utilization management review. Do you have experience with Utilization Review? Responsible for the review and evaluation of clinical information and documentation.
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Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.
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This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members on the telephone, reviewing medical records, reviewing cases which involves contract interpretation of behavioral health diagnoses, and utilizing knowledge of medical necessity criteria for all levels of behavioral health care from outpatient office visits to acute in-patient to out-patient office visits.
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Key Words: RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN.
$2,803 a weekFull-timeExpandUpdated Today - UpvoteDownvoteShare Job
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1+ years of utilization review experience using evidence-based guidelines. As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of our health services.
$114,300 a yearFull-timeRemoteExpandUpdated Today - UpvoteDownvoteShare Job
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Rising Medical Solutions has an opening for an Utilization Review Nurse , and we want to hear from you! Basically we are trying to fix a very broken healthcare system by reducing the cost of healthcare claims through bill review, case management, and utilization review.
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Prefer prior experience in case management, utilization review, or discharge planning. Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies.
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3 years clinical experience with 2 years' experience in utilization review, quality assurance, or statistical research. Registered Nurse (RN) with unrestricted license, or Licensed Clinical Social Worker.
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MedPro Healthcare Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Chicago, Illinois. The role of the case management nurse (RN) is to coordinate continuity of care for patients often as a liaison between the patient's family and healthcare organization.
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Maximus provides online PASRR Level I and Level II IDD screening and online Level of Care utilization review for long-term care populations across Indiana. The Clinical Review Coordinator Nurse will review summaries of findings by reviewing various information sources to identify service needs related to the individual's mental health or intellectual and developmental disabilities (IDD.
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Job Title: Utilization Review Nurse. Registered Nurse (RN) with unrestricted license in state. This position is responsible for performing accurate and timely Medical Review Of Claims Suspended for Medical Necessity, Contract Interpretation, Pricing; And To Initiate And/Or Respond To Correspondence From Providers Or Members Concerning Medical Determinations.
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utilization review nurse jobs in Chicago, IL
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