Current jobs related to Nurse Manager Utilization Review - Oswego NY United States - Clinical Management Consultants
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Utilization Review Nurse
4 weeks ago
Newtonville, NY, United States Albany Medical Center Full timeJob Title: Utilization Review NurseAlbany Medical Center is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will be responsible for reviewing patient admissions and continued stays to ensure that they meet medical necessity and are in compliance with regulatory requirements.Key Responsibilities:Conduct thorough...
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Utilization Review Nurse
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Slingerlands, NY, United States Albany Medical Center Full timeJob Title: Utilization Review NurseAlbany Medical Center is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will be responsible for reviewing patient admissions and continued stays to ensure that they meet medical necessity and are in compliance with regulatory requirements.Key Responsibilities:Conduct thorough...
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Utilization Review Nurse
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Westerlo, NY, United States Albany Medical Center Full timeJob Title: Utilization Review NurseAlbany Medical Center is seeking a skilled Utilization Review Nurse to join our team. As a key member of our Care Management department, you will play a critical role in ensuring the quality and appropriateness of patient care.Responsibilities:Conduct thorough reviews of patient records to identify potential issues and...
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Utilization Review Nurse
4 weeks ago
Malden Bridge, NY, United States Albany Medical Center Full timeJob Title: Utilization Review NurseAlbany Medical Center is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will be responsible for reviewing patient admissions and continued stays to ensure that they meet medical necessity and are in compliance with regulatory requirements.Key Responsibilities:Conduct thorough...
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Utilization Review Nurse
4 weeks ago
Lake Oswego, United States Providence RN Full timeJob SummaryThe RN Coordinator-Utilization Review supports the care of the patient through assessment, planning, implementation, and evaluation of appropriate services and resources to maximize optimum outcomes.This position works collaboratively with multiple disciplines, both internal and external to the organization, in effecting quality and cost-effective...
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Utilization Review Nurse
3 weeks ago
, FL, United States Trinity Health Full timeJob SummaryWe are seeking a skilled Utilization Review Nurse to join our team at Trinity Health. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the most appropriate level of care while minimizing unnecessary costs.Key ResponsibilitiesReview hospital admissions to determine medical necessity and ensure...
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Utilization Review Nurse
1 month ago
, FL, United States UF Health-Central Florida Full timeJob SummaryUF Health-Central Florida is seeking a skilled Utilization Review Nurse to join our team. As a key member of our healthcare team, you will play a critical role in ensuring the appropriate use of hospital resources and medical services.ResponsibilitiesDetermine the medical necessity of hospital admissions and continued staysFacilitate timely...
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Utilization Review Nurse
2 weeks ago
Washington, DC, United States MEDSTAR HEALTH Full timeJob SummaryWe are seeking a skilled Utilization Review Nurse to join our team at MedStar Health. As a key member of our case management team, you will play a critical role in ensuring high-quality patient care while promoting efficient use of hospital resources.Key ResponsibilitiesConduct thorough admission, concurrent, and retrospective case reviews to...
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Clinical Utilization Review Specialist
4 weeks ago
, MA, United States Trinity Health Of New England Full timeJob SummaryWe are seeking a skilled Clinical Utilization Review Specialist to join our team at Trinity Health Of New England. As a key member of our healthcare team, you will be responsible for performing utilization review and payer notification, establishing partnerships with site BPCI RN, and educating patients, families, and care teams about financial...
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RN - Utilization Review
3 weeks ago
Olympia, WA, United States Providence Full timeDescription 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...
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RN - Utilization Review
3 weeks ago
Tumwater, WA, United States Providence Full timeDescription 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...
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RN - Utilization Review
3 weeks ago
DuPont, WA, United States Providence Full timeDescription 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...
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Senior Director of Utilization Review
1 month ago
, TX, United States Other Executive Full timeJob SummaryWe are seeking a highly experienced and skilled Senior Director of Utilization Review to lead our case management operations and drive business growth. As a key member of our leadership team, you will be responsible for overseeing the development, implementation, and performance management of utilization review services across our enterprise.Key...
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Utilization Management Nurse
3 weeks ago
, CT, United States Yale University Full timeJob Title: Utilization Management NurseYale University is seeking a skilled Utilization Management Nurse to join our team. As a key member of our healthcare team, you will be responsible for ensuring that patients receive the most effective and efficient care possible.Key Responsibilities:Conduct thorough reviews of patient cases to assess the necessity and...
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Utilization Review RN
1 week ago
Apple Valley, CA, United States Providence Full timeDescription Provide prospective, retrospective and concurrent utilization review for St. Mary Medical Center. Provide clinical reviews and medical records daily during admission for all payers as required by the health plans. Requires a strong clinical background blended with a well-developed knowledge and skills in Utilization Management,...
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Utilization Review Nurse Registered Nurse
1 week ago
Winston-Salem, NC, United States Novant Health Full timeOverviewThe Utilization Review RN serves as a leader resource in the Utilization Review process. They collaborate with physicians and other members of the healthcare team to promote and adhere to regulatory compliance. The UR RN coordinates and conducts initial, concurrent, and retrospective medical necessity reviews. All Utilization Review activities are...
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Utilization Review Nurse Registered Nurse
6 days ago
Winston Salem, NC, United States Novant Health Full timeOverview The Utilization Review RN serves as a leader resource in the Utilization Review process. They collaborate with physicians and other members of the healthcare team to promote and adhere to regulatory compliance. The UR RN coordinates and conducts initial, concurrent, and retrospective medical necessity reviews. All Utilization Review activities are...
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RN Utilization Review Specialist
4 weeks ago
, MS, United States South Central Health System Full timeJob Title: RN Utilization Review SpecialistSouth Central Health System is seeking a highly skilled RN Utilization Review Specialist to join our team. As a key member of our Medical Staff Office, you will play a critical role in ensuring the quality and safety of patient care.Responsibilities:Collect and prepare data from medical records for OPPE and FPPE...
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Utilization Management Nurse
4 weeks ago
Philadelphia, PA, United States Health Partners Plans Full timeUtilization Management NurseWhy Choose Jefferson Health Plans? We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children's Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We are committed to creating a community where everyone...
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RN Utilization Review Case Manager
1 month ago
Columbus, OH, United States Mount Carmel Health System Full timeEmployment Type:Part timeShift:Day ShiftDescription:Utilization Review RN, Casual / PRNPosition Purpose: RN Utilization Review Case Mgr ensures that services are delivered in a manner that balances quality of care with efficiency, cost-containment and compliance.Minimum Qualifications:* Graduate of an accredited Registered/Professional Nursing program.*...
Nurse Manager Utilization Review
2 months ago
An award-winning acute care hospital located in central New York is currently searching for an experienced Nurse Manager Utilization Review to join their established healthcare system.
This regional leading medical center is home to over 500 inpatient beds and provides a wide variety of awarded acute care services. This location offers exceptional emergency and critical care, women’s health and birthing services, cardiology, oncology, behavioral health, surgical services, pediatrics, and much more. The Nurse Manager Utilization Review will join a system that strives to provide optimal patient outcomes and promote ongoing community health.
Reporting to the Director Case Management, the Nurse Manager Utilization Review will oversee the hospital’s case management and utilization review programs. Responsibilities include oversight of the medical necessity and denials management programs, ensures customer satisfaction, develops and enforces performance standards, provides training to new and existing staff, fosters positive relationships with payors and external vendors, and supports the overall mission of the organization.
What's Needed to Succeed:
- Bachelor’s degree in Nursing BSN
- Registered Nurse license in the state of New York or ability to obtain
- Prior leadership experience in an outpatient surgery setting
This region of central New York is home to a number of metro parks, delicious local restaurants, and many shopping areas. Many young professionals and families enjoy living in this area because you can always find something to do.
This respectable healthcare facility is prepared to offer a competitive compensation package including industry leading benefits.