Utilization Review Coordinator

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...

Job DescriptionPOSITION SUMMARY: Registered Nurse uses approved screening criteria (MCG®/CMS Inpatient List) to determine the medical necessity of a requested hospitalization and the appropriate level of care for that patient. Actively involved in the continued management of patient status/LOC. Provides consultative role as utilization management nurse to...

Description POSITION SUMMARY: Registered Nurse uses approved screening criteria (MCG/CMS Inpatient List) to determine the medical necessity of a requested hospitalization and the appropriate level of care for that patient. Actively involved in the continued management of patient status/LOC. Provides consultative role as utilization management nurse to...

DescriptionPOSITION SUMMARY:  Registered Nurse uses approved screening criteria (MCG®/CMS Inpatient List) to determine the medical necessity of a requested hospitalization and the appropriate level of care for that patient. Actively involved in the continued management of patient status/LOC. Provides consultative role as utilization management nurse to...

OverviewPerforms admission and continued stay utilization reviews and discharge screening to assure the medical necessity of hospital admission, appropriate level of care, continued stay and supportive services, and to examine delays in the provision of services. Coordinates care transitions from inpatient to the next level of care. Collaborates with...

Building Name: HHH - In-State Hybrid/RemoteRegularDepartment: CVMC - Care ManagementFull TimeStandard Hours: 40Biweekly Scheduled Hours:Shift: DayPrimary Shift: 7:30 AM - 4:00 AMWeekend Needs: NoneRecruiter: Kate DaviesPOSITION SUMMARYThe Utilization Review Nurse is responsible for ensuring the medical necessity and appropriate level of care of all hospital...

POSITION SUMMARYThe Utilization Review Nurse is responsible for ensuring the medical necessity and appropriate level of care of all hospital admissions and extended hospital stays, including psychiatry; affirming compliance with CMS’ Conditions of Participation regarding Utilization Management with annual review of the UM Plan and assisting with the...

POSITION SUMMARYThe Utilization Review Nurse is responsible for ensuring the medical necessity and appropriate level of care of all hospital admissions and extended hospital stays, including psychiatry; affirming compliance with CMS’ Conditions of Participation regarding Utilization Management with annual review of the UM Plan and assisting with the...

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

Registered Nurse RN - Utilization ReviewDetails * Department: Utilization Mgt * Schedule: M-F 8 hr days, ONSITE, exempt * Hospital: Ascension Sacred Heart Pensacola * Location: Pensacola, Florida Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term...

Department:Utilization ReviewShift:Primarily Days (United States of America)Employee Type:RegularPer Diem Type (if applicable):Minimum Pay Range:$55.77 - $69.71Job Description:POSITION SUMMARYThe Utilization Review Nurse (UR RN) uses a collaborative process, which provides professional accountability for the utilization of the health care resources to the...

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...

OverviewJoin our team as a day shift, PRN, Utilization Review Case Management Acute Care Rgistered Nurse in Albuquerque, NM.Fulfilling your purpose begins here:People First, Always. Here's how we take care of our people:* Competitive salaries, support teams and growth opportunities.Your team is bigger than your department:* Lovelace Health System includes...

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.Job Type:RegularScheduled Hours:40Work Shift:Day (United States of America)Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status based on the...

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Job Type:Regular Scheduled Hours:40 Work Shift:Day (United States of America) Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in 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...

Details* Department: Case Management* Schedule: Full Time Days M-F 8AM - 4PM No Weekends or Holidays* Hospital: Ascension Providence* Location: Currently remote but could change Southfield, MIBenefitsPaid time off (PTO)Various health insurance options & wellness plansRetirement benefits including employer match plansLong-term & short-term disabilityEmployee...

We are hiring a Fully Remote UM Nurse for a Health plan based out of New York! MLTC LTSS(home care, personal care, DME service reviews) Plan experience is required.Requirements: NY RN license (UM experience is required, MLTC LTSS experience required)Hours: Monday - Friday 9am-5pm or 8am-4pm (Full time hours only)Location: Remote (based out of NY)Pay:...