- Integrated Resources, Inc (Bakersfield, CA)
- … Review Nurse II represents the fully experienced level in utilization review and discharge planning activities. . Obtains and evaluates medical ... with attending physicians and others. . Formulates and documents discharge plans. . Provides on-going consultation and coordination with...the hospital. . Level II May assist in training Utilization Review Nurse I's. Knowledge… more
- The University of Vermont Health Network (Plattsburgh, NY)
- …Current New York State Registered Nurse license required.2. CCM Preferred. Utilization review and discharge planning experience preferred.3. Three years ... GENERAL SUMMARY:The Utilization Review RN monitors, collects and analyzes data and evaluates variances of resource utilization , complications and overall… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …team members as needed to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia...patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …as opportunities for improvement up the chain of command. Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure ... Licensure or other certifications:Preferred Educational Requirements: Bachelors DegreePreferred Experience: Discharge planning and utilization review … more
- Adventist Health (Rosemead, CA)
- Adventist Health is seeking a Registered Nurse (RN) Care Manager for a nursing job in Montebello, California.Job Description & RequirementsSpecialty: Care ... management program. Acts as a liaison between the patient, family, nurse , physicians, multidisciplinary team and patient's healthcare benefactor to optimize… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of their caseloads, provides coverage to Intake department, and assists with Utilization Review , Quality Assurance, and Performance Improvement activities as ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:12 Hr Morning - EveningNortheast Georgia Health System is rooted in a foundation of improving the health… more
- Adventist Health (Portland, OR)
- Adventist Health is seeking a Registered Nurse (RN) Home Health Care Manager for a nursing job in Portland, Oregon.Job Description & RequirementsSpecialty: Care ... management program. Acts as a liaison between the patient, family, nurse , physicians, multidisciplinary team and patient's healthcare benefactor to optimize… more
- Integrated Resources, Inc (Riverside, CA)
- …the interdisciplinary approach to providing continuity of care, including Utilization management, Transfer coordination, Discharge planning, and obtaining ... of post-hospital care planning. . Develops and coordinates the implementation of a discharge plan to meet patients identified needs. . Communicates the plan to… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR...killed while in such service. A DD214, Certificate of Discharge or Separation from Active Duty, or other official ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $113,309.04 -… 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** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
- Beth Israel Lahey Health (Burlington, MA)
- …Medical Center is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three ... Description:** **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate… more
- Martin's Point Health Care (Portland, ME)
- …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ... reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies… more
- Albany Medical Center (Albany, NY)
- Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) Utilization Review Nurse Salary Range: $31.28 - $51.61 per hour ... an assigned service. + Recent experience in case management, utilization management and/or discharge planning/home care in...Basic knowledge of computer systems with skills applicable to utilization review process. + Excellent written and… more
- Sharp HealthCare (San Diego, CA)
- …unrestricted. **Essential Functions** + Referral Coordination Ensures consistent application of the utilization review process for effective utilization of ... **Shift Start Time** **Shift End Time** California Licensed Vocational Nurse (LVN) - CA Board of Vocational Nursing &...medically necessary and/or not covered benefit and refer to Utilization Review Committee. Ensures that all denials… more
- Ascension Health (Wichita, KS)
- …additional specifics._ **Responsibilities** Provide health care services regarding admissions, case management, discharge planning and utilization review . + ... **Details** + **Department:** Utilization Review - Behavior Health +...precertification, reimbursement and claim denials/appeals. + Assess and coordinate discharge planning needs with healthcare team members. + May… more
- Ascension Health (Pensacola, FL)
- …additional specifics._ **Responsibilities** Provide health care services regarding admissions, case management, discharge planning and utilization review . + ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Trinity Health (Des Moines, IA)
- …or post discharge . . Carries out hospital programs and principles of utilization review in compliance with hospital policies and external regulatory agencies ... AND ABILITIES REQUIRED: . Current licensure as a registered nurse in the State of Iowa. . Five (5)...to reach resolutions to issues. . Specialty certification in Utilization Review within 12 months of hire… more
- Trinity Health (Fresno, CA)
- …The RN Manager of Utilization Management will ensure the timely delivery of utilization review , discharge planning and support case management and the ... Type:** Full time **Shift:** **Description:** **Are you an experience RN Manager, Utilization Review of Acute Care seeking your next adventure?** **Duration:**… more
- Actalent (Houston, TX)
- …managed care organization on a Sunday to Thursday OR Tuesday to Saturday basis doing utilization review for PAC patients. This role is looking for a June 3rd ... for RNs: $39.00 an hour Duties: + Telephonic position responsible for recommending discharge plans, assisting with transition of care, and managing the length of… more
- EM Key Solutions, Inc. (Eglin AFB, FL)
- …EM Key Solutions is seeking Registered Nurse (RN) for a full-time Utilization Review / Management position supporting the Medical Maintenance Team at Eglin ... Case Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health… more
