Utilization Review Nurse

About the RoleWe are seeking a highly skilled and experienced Director of Utilization Review and Operations to join our team at Ridgeview Institute Smyrna. As a key member of our leadership team, you will be responsible for overseeing the Utilization Review Program and ensuring the provision of effective treatment plans for all patients.Key...

Duties include by are not limited to:This is a Pre-Admission Screening position located in the Emergency Department shifts are three 10am-10pm one week, three 10am-10pm and one 10am-6pm the other week, with rotating every third weekend.Promotes effective and efficient utilization of clinical resources. Mobilizes resources as needed to achieve expected goal...

Position Overview: The role of the Healthcare Review Nurse is pivotal in ensuring that medical services are delivered with excellence, cost-effectiveness, and adherence to regulations. By systematically evaluating and auditing patient treatment records, the healthcare review nurse will prevent unnecessary procedures, ineffective treatments, and prolonged...

Position Overview: The role of the Healthcare Review Nurse is pivotal in ensuring that medical services are delivered with excellence, cost-effectiveness, and adherence to regulations. By systematically evaluating and auditing patient treatment records, the healthcare review nurse plays a crucial role in preventing unnecessary procedures, ineffective...

Position Overview: The role of the Healthcare Review Nurse is pivotal in ensuring that medical services are delivered with optimal quality, cost-effectiveness, and adherence to regulations. By systematically evaluating and auditing patient treatment records, the healthcare review nurse will safeguard against unnecessary procedures, ineffective treatments,...

Clinical Review Nurse I - Medicare Part ANational Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.Location:This is a virtual position and preferred candidates reside within 50 miles...

Join a dedicated healthcare community focused on prioritizing healthThe Utilization Management Registered Nurse plays a crucial role in leveraging clinical expertise to facilitate the organization, documentation, and communication of medical services and benefit determinations. This position involves diverse responsibilities that often require analytical...

RESPONSIBLE FOR: The purpose of this position is to ensure that acute hospital admission have the appropriate level of care, patient status, plan of care and meet medical necessity for an acute hospitalization. This role monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensures that the...

Position OverviewThe Energy & Utilities Analyst will operate under the guidance of a senior consultant or project manager to aid in crafting solutions for the technical and economic challenges faced by our energy and utility clientele. This role involves assisting with power system evaluations that assess both fossil fuel and renewable energy sources, as...

Become an integral part of our compassionate community focused on health and wellnessThe Utilization Management Registered Nurse 2 employs clinical nursing expertise to facilitate the coordination, documentation, and communication of medical services and benefit administration decisions. The responsibilities of the Utilization Management Nurse 2 are diverse...

Welcome to Broadstaff, a premier staffing partner focused on the Telecom - Wireless Infrastructure sector. Our mission is to connect exceptional talent with outstanding career opportunities, fostering professional growth and success.Position Overview:The successful candidate will be expected to meet the following qualifications:A Bachelor's degree from an...

Position Overview:This role requires extensive travel across the United States, with candidates able to be based from any location. Experience Requirements:We are seeking a qualified individual with a background as a CONSTRUCTION MANAGER specifically in Utility Scale solar projects. Company Profile:A leading manufacturer and installer of Solar Tracking...

TravelNurseSource is working with Amare Medical Network to find a qualified Telemetry RN in Riverdale, Georgia, 30274Pay Information $1,710 per weekAbout The Position The Telemetry Nurse carries out patient assignments and assumes primary care responsibilities that promote health, prevent illness, restore health, and ease suffering for patients released from...

TravelNurseSource is working with Remede Group to find a qualified RNFA RN in Atlanta, Georgia, 30301 About The Position JOB DESCRIPTION - REGISTERED NURSE (A) Job Summary:The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as the primary goal, the Registered Nurse...

TravelNurseSource is working with Remede Group to find a qualified RNFA RN in Atlanta, Georgia, 30301About The PositionJOB DESCRIPTION - REGISTERED NURSE (A)Job Summary The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as the primary goal, the Registered Nurse...

Job OverviewAs a key member of the healthcare team, you will be responsible for conducting utilization assessments, quality evaluations, and discharge planning for patients admitted to inpatient facilities lacking onsite Quality Review Management (QRM) personnel. Your role will involve telephonic evaluations for initial admissions and ongoing reviews, as...

TravelNurseSource is working with Lark Medical Staffing to find a qualified ER/Trauma RN in Lawrenceville, Georgia, 30046Hit Apply below to send your application for consideration Ensure that your CV is up to date, and that you have read the job specs first.About The PositionHigh-Paying Travel Opportunity with Lark Medical Staffing Location:Nationwide, Lark...

TravelNurseSource is working with Atlas MedStaff to find a qualified OR RN in Augusta, Georgia, 30912Pay Information $1,832 per weekAbout The Position Atlas Medstaff is currently seeking candidates in the RN (OR) profession for a 13 week contract in the Augusta, Georgia area. Atlas Medstaff is a premier staffing firm dedicated to matching outstanding talent...

Overview10E is a specialized 23-bed unit dedicated to the care of patients with intricate medical conditions, including Chronic Pain and various diagnoses such as Pneumonia, COPD, Heart Failure, Sickle Cell, Behavioral Health, Renal Failure, and Diabetes.This role offers a unique chance to engage in unit committees aimed at enhancing quality outcomes. We...

PRIOR AUTHORIZATION NURSE JOB Summary:Provide processing and communication of specialty medication prior authorization (PA) requests reviewed by the Specialty Medical Prior Authorization department.Work with physician office staff and customer service, admissions and pharmacy operations departments to communicate prior authorization status.Oversee fax...