- 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
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah, or obtain one...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… 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
- CommonSpirit Health Mountain Region (West Jordan, UT)
- …you flourish and leaders who care about your success. As a Registered Nurse , RN Case Manager you'll advocate for patients while collaborating closely with ... discretion, and independent judgment in assessing/reassessing, facilitating care coordination, utilization management, and patient advocacy. + Assure medical appropriateness… more
- CVS Health (Salt Lake City, UT)
- …RN with behavioral health background. Preferred Qualifications + 3 years Managed care/ utilization review experience preferred. + Crisis intervention skills and ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in… more
- HCA Healthcare (West Valley City, UT)
- …Center have the opportunity to make a real impact. As an Operating Room Registered Nurse you can be a part of change. **Benefits** Utah Surgical Center, offers a ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- HCA Healthcare (Bountiful, UT)
- …satisfaction and personal growth, we encourage you to apply for our OR Registered Nurse PRN opening. We review all applications. Qualified candidates will be ... have the PRN career opportunities as an OR Registered Nurse PRN you want with your current employer? We...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… 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
- Humana (Salt Lake City, UT)
- …to improve the lives of others. **Essential Duties and Responsibilities:** + Review PA requests for home health services, durable medical equipment, outpatient ... Medicaid criteria, iCare guidelines, and PA Department policies and procedures. + Review PA requests for inpatient medical stays, skilled nursing facility stays,… more
- Fresenius Medical Center (West Valley City, UT)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Marriott (Salt Lake City, UT)
- …workers' compensation losses. The NCM is responsible for conducting first level Utilization Review and coordinates subsequent levels if necessary, as required ... **Additional Information** Nurse CARE Manager (CARE - Coordinated Action and...that may include multiple states. + Conducts first level utilization review per jurisdictional requirements. + Coordinates… more
- Evolent Health (Salt Lake City, UT)
- …with call center staff. Initial clinical reviewers are supported by Physician clinical review staff (MDs) in the utilization management determination process. + ... Reviewer, you will be a key member of the utilization management team. We can offer you a meaningful...You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not… 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
- Highmark Health (Salt Lake City, UT)
- …network providers to support key clinical transformation programs with a focus on utilization of appropriate care. The team member works with internal and external ... is responsible for building relationships, engaging clinicians, educating on Utilization Management policies and processes, developing workflows and resources, and… more
- HCA Healthcare (Salt Lake City, UT)
- …position control, scheduling excellence, productivity management, and premium pay utilization . Maintains staffing to ensure appropriate patient care. + Manages ... operating expenses including the utilization of supplies and equipment. Identifies cost reduction opportunities...- Required + Currently licensed as a registered professional nurse in the state(s) in which he or she… more
- Intermountain Health (Provo, UT)
- …Improvement Coordinator, the following job essentials apply: + Conducts chart review utilizing clinical expertise to aggregate, assess, and interpret information in ... order to evaluate the quality of clinical care, utilization of appropriate services, and adherence to Intermountain and...improve clinical outcomes and patient care. + Prepares case review summary for review with TPM and… more
- University of Utah Health (Salt Lake City, UT)
- …thorough on-site or telephonic assessment of potential patients including chart review , clinical assessment and interaction with physicians, nurses and therapists ... process inclusive of completion of the pre-admission assessment tool and appropriate review by the rehab physician with signature. + Educates patients, family… more
- Vyaire Medical (Salt Lake City, UT)
- …of new products and services; make recommendations to drive client acceptance and utilization of new medical devices. Facilitate UPE's for new products. + Develop, ... Minimum 5 years clinical experience as a respiratory therapist or critical care nurse required + Ability to meet requirements in vendor credentialing services, eg… more