Utilization/Concurrent Review Nurse

Under general supervision of the Director of Case Management, the Utilization Review Nurse provides a clinical review of cases using medical necessity criteria to determine the medical appropriateness of inpatient and outpatient services. Provides feedback and assistance to other members of the healthcare team regarding the appropriate use of resources and...

Utilization Review RNOverview Baylor St. Luke's Medical Center is an 881-bed quaternary care academic medical center that is a joint venture between Baylor College of Medicine and CHI St. Luke's Health. Located in the Texas Medical Center, the hospital is the home of the Texas Heart Institute, a cardiovascular research and education institution founded in...

Registered Nurse RN Concurrent UM Review WellMed Compact LicenseOpportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and...

UTILIZATION REVIEW NURSE (RN)Randallstown, MDNORTHWEST HOSPITALNW CARE MANAGEMENTFull-time - Day shift - 8:00am-4:30pmRN Other81988Posted:March 21, 2024Apply NowSave JobSavedSummaryPosition Summary:Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to...

RN Case Manager/UR ReviewerJOIN OUR TEAM!!! Are you looking to be one of the team? To be part of the family and not just another number? Are you looking for a positive work environment where teamwork and diversity are key? We value your contributions. Every role in our hospital has an impact on each of our patients. We work hard to make sure our employees...

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an...

Utilization Review NursePer Diem 1648 Huntingdon Pike Nursing RN/LPN Day SUMMARY OF JOB: To review each admission for appropriate assignment of level of care based upon clinical guidelines as well as to review documentation for continued stays daily and provide clinical information including assessments and outcomes for all payers and all levels of care...

The Utilization Review Nurse assists the utilization review process taking on various tasks including data collection of demographic, claim and medical information; analysis; and outcomes reporting. Utilizes standards of care, evidence based practices, Medicare and Medicaid and organizational coverage guidelines to assure members receive high quality, cost...

UTILIZATION REVIEW NURSE (RN) - PRNBaltimore, MDSINAI HOSPITALUTILIZATION REVIEWPRN - As Needed - 8:00am-4:30pmRN Other82413Posted:March 21, 2024Apply NowSave JobSavedSummaryPosition Summary:Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to decrease...

Job Description:This position will be remote role for Nurses in MichiganShould have a valid MI RN LicenseShould Have utilization management experience.Should have experience completing post-acute reviews for the inpatient rehab, skilled nursing facility settings previously.The candidate should be well versed in coordination of care activities along with...

TalentBurst, Inc is seeking a travel nurse RN Utilization Review for a travel nursing job in Irving, Texas.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 06/17/2024Duration: 11 weeks36 hours per weekShift: 12 hoursEmployment Type: TravelPosition - RN Utilization Review Shift - Monday-Friday 8 hours Hours - 40...

Health Advocates Network is urgently hiring Utilization Review Registered Nurses (RNs) in the Medford, OR area. Must have 2 years of Discharge Planning and Utilization Review experience. + Pay Rate: $2,760 weekly + Specialty: Utilization Review Registered Nurse (RN) + Shift Info: Day + 13 Week Contracts and more available! RN Qualification and...

Description ****Average hourly rate is $22.60 (including wage, incentives, bonuses, overtime, shift differential, etc.)****      Utilization ReviewerPathway Family Services, LLC. provides resources for youth and families through their Independent Living Program, TRAIL (Teens Reaching Adult Independent Living), Psychiatric Residential Treatment Facility,...

Summary The individual in this position is responsible to facilitate effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and right to self-determination. The individual in this position has overall responsibility for ensuring that care is...

Job DescriptionDuties and Responsibilities:Initial authorizations of outpatient physical therapy services: Reviews and authorizes services that meet criteria, along with supporting documentation. It is the responsibility of the URC to ensure outpatient physical therapy services are provided at the appropriate level and are received per the defined plan...

Education & Qualifications: Graduate from an accredited school of nursing (RN) required, bachelors preferred. Knowledge and skills necessary to provide care appropriate to the population served in the CM Department. Two (2) or more year’s clinical experience preferred. Acute care or community social agency case management experience preferred. Utilization...

Please Note: This is an onsite position supporting the Emergency Department at Champlain Valley Physicians Hospital (CVPH) in Plattsburgh, NY.GENERAL SUMMARY:The Utilization Review RN monitors, collects and analyzes data and evaluates variances of resource utilization, complications and overall quality of care based on benchmarked criteria or established...

Please Note: This is an onsite position supporting the Emergency Department at Champlain Valley Physicians Hospital (CVPH) in Plattsburgh, NY.GENERAL SUMMARY:The Utilization Review RN monitors, collects and analyzes data and evaluates variances of resource utilization, complications and overall quality of care based on benchmarked criteria or established...

Sign-on Bonus and Relocation Reimbursement available!Receive 17% weekday nights, 26% weekend nights, or 15% weekend day shift differentials!Department: HIM Clinical DocumentationFTE: 1.00Full TimeShift: DaysPosition Summary:Responsible for concurrent review of appropriate and complete clinical documentation in the electronic medical record to support...

Unit Description: The Utilization Review Team monitors, collects and analyzes data and evaluates variances of resource utilization, complications and overall quality of care based on benchmarked criteria or established practices. Utilizing these skills assists the Medical Center in providing optimal care in a cost effective manner and promotes the efficient...