- R1 RCM (Salt Lake City, UT)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our ... in this remote position. **Here's what you will experience working as a Utilization Review Nurse :** + Perform initial admission and continued stay reviews… more
- Lincoln Financial Group (Salt Lake City, UT)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- University of Utah Health (Salt Lake City, UT)
- …LOS, high dollar and frequent utilizers. + Collaborate with unit case manager, utilization review nurse and other organization staff on establishing ... and continuum of care providers. + Provides guidance to utilization review staff and providers on admission...Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one… more
- CVS Health (Salt Lake City, UT)
- …UM ( utilization management) experience within an inpatient/outpatient setting, concurrent review or prior authorization. + 1+ years Managed Care (MCO) preferred. ... queue working with providers to secure additional information for prior authorization review . This candidate will utilize clinical skills to coordinate, document and… more
- Intermountain Health (Murray, UT)
- **Job Description:** The Healthy Connections (Care Management and Utilization Review ) AVP at Select Health oversees development and evaluation of utilization ... and innovative management of Select Health's Health Services care management and utilization management programs. Programs include but are not limited to acute,… more
- Sedgwick (Salt Lake City, UT)
- …and consult review ; and two (2) years of experience in daily application of nurse auditing, utilization review and bill review . **Skills & ... Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Bill Review **PRIMARY PURPOSE** **:** To review hospital...RN Bill Review **PRIMARY PURPOSE** **:** To review hospital and professional medical bills from providers including… more
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- …intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, ... Summary The Referral Coordination Team (RCT) Registered Nurse (RN) is responsible for executing a streamlined...Legacy Viewer), Vista Imaging Display, PPMS and TriWest Portal. Review requests for VA internal care as well as… more
- Intermountain Health (Salt Lake City, UT)
- …needs in area(s) of responsibility. Completes documentation as required. + Performs utilization review activities to provide patient appropriate, timely, and ... **Job Description:** The Nurse Case Manager utilizes clinical expertise and critical...+ Case management Certification. + Experience in Case management, Utilization review , and/or discharge planning. **Physical Requirements:**… more
- HCA Healthcare (Draper, UT)
- …your career path, we encourage you to apply for our Operating Room Registered Nurse opening. We review all applications. Qualified candidates will be contacted ... have the career opportunities as an Operating Room Registered Nurse you want in your current role? We invest...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- Prime Therapeutics (Salt Lake City, UT)
- …clinical experience. + Experience in managed care, specialty drugs, care management and utilization review . + Meets Magellan Credentialing criteria. + At minimum ... and drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description Summary** Under supervision, is responsible for performing… more
- HCA Healthcare (Salt Lake City, UT)
- …about delivering patient-centered care?** Submit your application for Operating Room Registered Nurse position and spend more time at the bedside with the patient. ... Summary and Qualifications** We are seeking an Operating Room Nurse for our ambulatory surgery center who demonstrates the...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- Highmark Health (Salt Lake City, UT)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements the effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to assure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
- University of Utah Health (Salt Lake City, UT)
- …education in healthcare or a related field. + One year of experience in a utilization review or case management environment. + Basic Life Support Health Care ... coordination of care activities under the direction of a registered nurse and/or social worker. The incumbent interacts with representatives from insurance… more
- HCA Healthcare (Salt Lake City, UT)
- …Course (BLS or BCLS) and Certification. + Certification in case management or utilization review preferred. + InterQual experience preferred. For 150 years, St. ... one another. Your acute care background as a registered nurse will give you the experience you need to...supporting a balance of optimal care and appropriate resource utilization . + Direct activities to identify and provide for… more
- University of Utah Health (Salt Lake City, UT)
- …+ Negotiates with third party payers relative to benefit levels, eligibility, utilization review , and reimbursement. + Identifies actual and potential delays ... **Licenses Required** + **One of the following** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under… more
- HCA Healthcare (Bountiful, UT)
- …and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of daily hospital case ... interdisciplinary teams and external stakeholders. The Director is a registered nurse with responsibility for all operational aspects of the department. This… more
- Veterans Affairs, Veterans Health Administration (South Jordan, UT)
- …(PACT) or the clinical team within the Specialty they are supporting, to review clinic appointment availability ( utilization ) to ensure that clinic schedules are ... of medical clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical… more