Current jobs related to RN, Registered Nurse Utilization Review - San Antonio - Christus Health
-
RN Utilization Review Specialist
1 month ago
San Antonio, Texas, United States CHRISTUS Health Full timeJob Summary:The RN Utilization Review Specialist is responsible for ensuring the clinical appropriateness of care provided to patients and optimizing hospital resource utilization. This role involves performing pre-admission, concurrent, and retrospective reviews to ensure that services are necessary and meet regulatory requirements. The RN Utilization...
-
Utilization Review Nurse
4 weeks ago
San Angelo, United States Shannon Health Full timeJob Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the UM program by developing and/or maintaining effective and efficient processes for determining the appropriate admission status based on the regulatory and...
-
Registered Nurse
4 weeks ago
San Leandro, United States Incredible Health Full timeHospitals on Incredible Health are actively hiring and accepting applications in the San Leandro, CA area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encouraged to apply: Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift, night shift,...
-
Registered Nurse
4 weeks ago
San Leandro, CA, United States Incredible Health Full timeHospitals on Incredible Health are actively hiring and accepting applications in the San Leandro, CA area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encouraged to apply: Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift, night shift, and...
-
Travel Registered Nurse
2 weeks ago
San Diego, California, United States Healthcare Staffing Plus Full timeJob Title: Travel Registered Nurse - Utilization Review SpecialistHealthcare Staffing Plus is seeking a skilled Travel Registered Nurse - Utilization Review Specialist to join our team. As a Utilization Review Nurse, you will play a critical role in developing and maintaining policies and procedures for utilization management.Key Responsibilities:Collaborate...
-
Registered Nurse
1 month ago
San Leandro, California, Alameda County, CA, United States Incredible Health Full timeHospitals on Incredible Health are actively hiring and accepting applications in the San Leandro, CA area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encouraged to apply: Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift, night shift,...
-
San Diego, California, United States Healthcare Staffing Plus Full timeJob Title: Travel Registered Nurse Utilization Review SpecialistJob Summary:Healthcare Staffing Plus is seeking a skilled Travel Registered Nurse Utilization Review Specialist to join our team. As a Utilization Review Registered Nurse, you will be responsible for assisting in developing and maintaining policies and procedures for the Service Area or Medical...
-
Utilization Review Nurse
1 month ago
San Francisco, California, United States Vivo HealthStaff Full timeJob Title: Utilization Review RNVivo HealthStaff is seeking a skilled Utilization Review RN to join our team in San Francisco. This hybrid position requires 1-2 days of on-site work per week.Job Summary:We are looking for a highly motivated and detail-oriented RN to collaborate with our healthcare team to ensure effective patient outcomes. The ideal...
-
Utilization Review Nurse
2 weeks ago
San Francisco, California, United States Vivo HealthStaff Full timeJob Title: Utilization Review RNVivo HealthStaff is seeking a skilled Utilization Review RN to join our team in San Francisco. This hybrid position requires 1-2 days of on-site work per week.Job SummaryWe are looking for a highly motivated and detail-oriented RN to collaborate with our healthcare team to ensure effective patient outcomes. The ideal candidate...
-
Travel Nurse Utilization Review Specialist
2 weeks ago
San Diego, California, United States Healthcare Staffing Plus Full timeJob Title: Travel Registered Nurse Utilization ReviewHealthcare Staffing Plus is seeking a skilled Travel Registered Nurse Utilization Review professional to join our team. As a Utilization Review Nurse, you will play a critical role in ensuring the efficient use of healthcare resources and promoting high-quality patient care.Job Summary:This is a 13-week...
-
Travel Registered Nurse
6 days ago
San Diego, California, United States Healthcare Staffing Plus Full timeJob Title: Travel Registered Nurse - Utilization Review SpecialistJob Summary:We are seeking a skilled Travel Registered Nurse - Utilization Review Specialist to join our team at Healthcare Staffing Plus. As a Utilization Review Specialist, you will play a critical role in developing and maintaining policies and procedures for the Service Area or Medical...
-
Travel Nurse RN Utilization Review
4 weeks ago
San Mateo, California, United States Supplemental Health Care Full timeJob Title: Utilization Review Registered NurseSupplemental Health Care is seeking a skilled Utilization Review Registered Nurse to join our team for a 13-week assignment at a partnering hospital in San Mateo, California.Job Summary:We are looking for a dedicated and experienced Registered Nurse to provide Utilization Review services in a fast-paced hospital...
-
Healthcare Utilization Review Specialist
5 days ago
San Bernardino, California, United States Molina Healthcare Full timeJob Title: Healthcare Utilization Review SpecialistCare Review Clinician, Prior Authorization (Registered Nurse, or LVN)Key Responsibilities:Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare and its members.Refers appropriate prior authorization requests to Medical Directors.Collaborates with multidisciplinary...
-
Travel Registered Nurse
3 months ago
San Diego, United States Healthcare Staffing Plus Full timeCompensation : $60 - $60 Hourly Client Job Ref ID : 138329 Shift Description : 06/01/2023 Travel Registered Nurse - Utilization Review San Diego, California, United States - 91911 Job Title: Travel Nurse - Utilization Review Shift: Evening or night shifts - 36 hours (weekends rotating) Duration: 13 weeks Start Date: 06/01/2023 Hourly Pay: $60 OT: 1.5...
-
Travel Nurse
2 weeks ago
San Diego, California, United States Healthcare Staffing Plus Full timeJob Title: Travel Registered Nurse - Utilization ReviewWe are seeking a skilled Travel Registered Nurse to join our team in San Diego, California. As a Utilization Review Nurse, you will play a critical role in ensuring the efficient use of healthcare resources and promoting high-quality patient care.Job Summary:The Travel Registered Nurse - Utilization...
-
Utilization Review Nurse
6 days ago
San Francisco, California, United States MarinHealth Medical Center Full timeAbout MarinHealth Medical CenterMarinHealth Medical Center is a leading healthcare provider in the North Bay area, offering a comprehensive range of services to meet the diverse needs of our community. We are seeking a highly skilled Utilization Review Nurse to join our team of dedicated healthcare professionals.Job Summary:The Utilization Review Nurse will...
-
Travel Registered Nurse Utilization Review
2 weeks ago
San Diego, United States Healthcare Staffing Plus Full timeCompensation : $60 - $60 Hourly Client Job Ref ID : 138758 Shift Description : Day shifts - 36 hours (weekends rotating) Travel Registered Nurse Utilization Review San Diego, California, United States - 91911 Job Title: Travel Nurse - Utilization Review Number of positions: 1 Shift: Day shifts- 36 hours (weekends rotating) Duration: 13 weeks Start...
-
Utilization Review Nurse
2 weeks ago
San Bernardino, California, United States Actalent Full timeJob SummaryThe Utilization Review Nurse is a key member of the Care Coordination team at Actalent. This role involves coordinating continuing care and outside services for value-based risk members, collaborating with hospitals and primary care physicians to ensure optimal patient outcomes.Responsibilities include:Repatriating stable members from non-member...
-
Utilization Review Coordinator
1 month ago
San Antonio, Texas, United States San Antonio Behavioral Health Full timeJob Title: Utilization Review CoordinatorJob Summary:The Utilization Review Coordinator plays a critical role in ensuring the effective and efficient use of hospital services. This position conducts utilization reviews to determine if patients are receiving care appropriate to their illness or condition. The coordinator monitors patient charts and records to...
-
Utilization Review Nurse
3 weeks ago
San Bernardino, California, United States Actalent Full timeJob Title: Utilization Review NurseJoin Actalent, a global leader in engineering and sciences services and talent solutions, as a Utilization Review Nurse. In this role, you will be responsible for coordinating continuing care and outside services for value-based risk members, collaborating with hospitals and primary care physicians, and monitoring patients...
RN, Registered Nurse Utilization Review
4 months ago
Summary:
The RN Utilization Review II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This RN is responsible for performing a variety of pre-admission, concurrent, and retrospective UM related reviews and functions. They must competently and accurately utilize approved screening criteria (InterQual/MCG/Centers for Medicare and Medicaid Services “CMS” Inpatient List). They effectively and efficiently manage a diverse workload in a fast-paces, rapidly changing regulatory environment and are responsible for maintaining current and accurate knowledge regarding commercial and government payors and Joint Commission regulations and guidelines related to UM. This RN effectively communicates with internal and external clinical professionals, efficiently organizes the financial insurance care of the patients, and relays clinical data to insurance providers and vendors to obtain approved certification for services. The RN Utilization Review Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS.
CHRISTUS Santa Rosa Hospital - Westover Hills (CSRH-WH) is a 150-bed hospital serving the fastest growing area of San Antonio. Specialized care includes orthopedic and surgical services, ICU, women’s services, a newborn nursery, comprehensive cardiovascular care from diagnostics to open heart surgery, vascular lab, sleep center, emergency services, the CHRISTUS Weight Loss Institute, wound care, rehabilitation, and more. The campus also boasts an Outpatient Imaging Center and three medical plazas, one of which houses our CHRISTUS Santa Rosa Family Medicine Residency Program and CHRISTUS Santa Rosa Family Health Center.
Requirements:
BSN Degree from an accredited nursing program or proven success as Registered Nurse Utilization Review I role
Familiarity with criteria sets including InterQual and MCG preferred
Excellent verbal and written communication
Critical and analytical thinking skills
Demonstrated clinical competency
Three to Five years experience in case management or utilization review or proven success as Registered Nurse Utilization Review I role
RN License in state of employment or compact required
CPR certification preferred
Certification in Case Management preferred
Work Type:
Per Diem As Needed
EEO is the law - click below for more information:
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at .%{{advertiserId}}% %%{{category}}%%
