UTILIZATION REVIEW RN

The Utilization Review RN is responsible for utilization management and utilization review for prospective, concurrent, or retrospective review.This position functions as a part of a multidisciplinary team, including physicians, social workers, discharge planning assistants and payers. The Utilization Review RN performs reviews of current inpatient services,...

OverviewUtilization Review RN is responsible for the review of medical records for appropriate admission status and continued hospitalization. Works in collaboration with the attending physician, consultants, second level physician reviewer and the Care Coordination staff utilizing evidence-based guidelines and critical thinking. Collaborates with the...

**Overview**Utilization Review RN is responsible for the review of medical records for appropriate admission status and continued hospitalization. Works in collaboration with the attending physician, consultants, second level physician reviewer and the Care Coordination staff utilizing evidence-based guidelines and critical thinking. Collaborates with the...

The Compliance Specialist ensures staff compliance with Utilization Management regulations, including NCQA, CMS, and state requirements. Responsibilities include monitoring medical reviews, overseeing Inter. Qual application, and coordinating busines RN, Healthcare, Compliance Specialist, Staffing

GetMed Staffing is searching for a strong Utilization Review RN to assist our traveler-friendly client. A minimum of 1-2 years of experience is required. Traveling with GetMed Staffing offers the unique opportunity to gain diverse experiences, both personally and professionally. Gain experience that matters.

As a Valleywise Utilization Review RN Coordinator, you are part of a multidisciplinary team providing exceptional care to our patients. As a Utilization Review RN Coordinator, you work under the direction of the Manager of Care Management as part of the inpatient Care Management Team. You are responsible for determining the appropriateness of patient status...

Title: RN Utilization Review II Description: 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...

The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining effective, efficient processes for determining the appropriate admission status based on...

At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to...

Benefits* Nursing Student Loan Debt Repayment and Tuition Assistance* Tuition, Travel, and Wireless Service Discounts* Employee Assistance Program to support mental health* Employee Foundation to assist financially with unforeseen hardships* Diverse, Equitable, and Inclusive (DEI) workplace with DEI committee. DEI is a part of our company's DNA.* Variable...

CornerStone Medical is looking for a Registered Nurse Utilization Review for a state of the art hospital system in Irving, TX. This is an onsite role. Current RN Compact License required 8 am - 5 pm Monday - Friday $37/ Hr Summary: The RN Utilization Registered Nurse, Registered, Nurse, RN, Clinical, Healthcare, Staffing

Job Summary:At Gritman, we pride ourselves on being the premier healthcare employer on the Palouse. We bring exceptional care that's close to home for the members of our community. We are seeking a Staff RN to join our Utilization Review/Case Management team. The Utilization Review Nurse (UR) has skills in areas of Utilization Management (UM), medical...

Job DetailsJob LocationTexas Institute for Surgery LL SURG - Dallas, TXSalary Range$38.00 - $43.00 HourlyJob CategoryHealth CareDescriptionJob Summary:The Utilization Management Nurse will provide precertification of inpatient hospitalizations and all outpatient procedures and services requiring authorizations. This role performs telephonic and/or concurrent...

About Hilton Head Regional HealthcareHilton Head Regional Healthcare provides comprehensive healthcare to the Lowcountry at four locations including Coastal Carolina Hospital, Hilton Head Hospital, the Bluffton Medical Campus and the Bluffton-Okatie Outpatient Center. Coastal Carolina Hospital (CCH) is a 41-bed acute care hospital located in Hardeeville,...

About Hilton Head Regional HealthcareHilton Head Regional Healthcare provides comprehensive healthcare to the Lowcountry at four locations including Coastal Carolina Hospital, Hilton Head Hospital, the Bluffton Medical Campus and the Bluffton-Okatie Outpatient Center. Coastal Carolina Hospital (CCH) is a 41-bed acute care hospital located in Hardeeville,...

Per Diem1648 Huntingdon PikeNursing RN/LPNDaySUMMARY 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 as required by the payer. Work...

OverviewAs a Utilization Review Nurse, you will work under the direct supervision of the Supervisor, Utilization Review and Clinical Documentation Improvement, this role will be responsible for providing clinically based concurrent and retrospective review of inpatient medical records to evaluate the documentation and utilization of acute care services. This...

Job SummaryThe 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...

Victor Valley Global Medical CenterVictorville, CACoordinates and reviews all medical records, as assigned to caseloadActively participates in Case Management and Treatment Team meetingsServes as on-going educator to all departmentsResponsible for reviewing patient charts in order to assess whether the criteria for admission and continuation of treatment is...

Fortus Healthcare Resources is seeking a Travel Utilization Review RN, Care Manager Registered Nurse for an immediate opening in Kealakekua, HI . Registered Nurse, Care Manager, RN, Registered, Nurse, Manager, Healthcare, Staffing