Current jobs related to Utilization Review - Jacksonville FL United States - Saint Vincent's Medical Center Riverside
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Leesburg, FL, United States UF Health-Central Florida Full timeOverview UF Health Leesburg Hospital has been serving the health care needs of our community for 58 years. The hospital offers advanced cardiac care including one of the largest cardiothoracic surgery programs in the state. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in...
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Leesburg, FL, United States UF Health-Central Florida Full timeOverview UF Health Leesburg Hospital has been serving the health care needs of our community for 58 years. The hospital offers advanced cardiac care including one of the largest cardiothoracic surgery programs in the state. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in treating...
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RN-Utilization Review
4 weeks ago
Austin, TX, United States Ascension Seton Northwest Full timeRN-Utilization ReviewDetails * Department: UR Review * Schedule: FT - Days * Location: Austin, TX - Remote after 4 weeks of training onsite Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental...
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Clinical Nurse Specialist, Utilization Review
2 weeks ago
Jacksonville, Florida, United States Baptist Medical Center Jacksonville Full timeClinical Nurse Specialist, Utilization Review Job OverviewBaptist Medical Center Jacksonville is seeking a dedicated Clinical Nurse Specialist to join our Utilization Review team.Role ResponsibilitiesThe Utilization Review Nurse is tasked with evaluating patient records to ascertain the appropriate classification of care (inpatient, observation, outpatient)...
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Leesburg, FL, United States UF Health-Central Florida Full timeOverviewUF Health Leesburg Hospital has been serving the health care needs of our community for 58 years. The hospital offers advanced cardiac care including one of the largest cardiothoracic surgery programs in the state. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in treating...
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LPN for Utilization Review
2 weeks ago
Fontana, CA, United States Pyramid Consulting Full timePyramid Consulting is currently looking for a dedicated Licensed Practical Nurse (LPN) to fill a Utilization Review role on a local contract basis.Position OverviewThe selected candidate will be responsible for:Specialty: Utilization ReviewDiscipline: LPNEmployment Type: Local ContractKey ResponsibilitiesThe LPN will engage in:Coordinating...
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Utilization Review Coordinator
4 days ago
Jacksonville, Florida, United States UHS Full timeJob SummaryWe are seeking a skilled Utilization Review Coordinator to join our team at River Point Behavioral Health, a subsidiary of Universal Health Services (UHS). As a Utilization Review Coordinator, you will play a critical role in ensuring the quality and appropriateness of patient care.Key ResponsibilitiesMonitor treatment activities and collaborate...
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Utilization Review Nurse
2 weeks ago
Bremen, IN, United States Neuropsychiatric Hospitals Full timeAbout Us:HEALING THE BODY AND MINDFounded fifteen (15) years ago, NeuroPsychiatric Hospital is the largest hospital system in the nation providing care to patients with both neurological and medical needs. We are unique in that we serve a population which others have been previously been unable to, largely due the patient’s underlying medial issues. Our...
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Leesburg, FL, United States UF Health-Central Florida Full timeOverview UF Health Leesburg Hospital has been serving the health care needs of our community for 58 years. The hospital offers advanced cardiac care including one of the largest cardiothoracic surgery programs in the state. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in treating...
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Utilization Review RN
2 weeks ago
Austin, TX, United States Ascension Full timeDetails Department: Utilization ReviewSchedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays requiredFacility: Ascension Care Management InsuranceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &...
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RN - Utilization Review
6 days 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
18 minutes 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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Utilization Review RN
4 weeks ago
Seattle, WA, United States Swedish Health Services Full timeDescription Remote - Utilization Review RN On call/Per diem The Utilization Review (UR) Nurse has a strong clinical background blended with a 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...
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Utilization Review RN
6 days ago
Seattle, WA, United States Swedish Health Services Full timeDescription Remote - Utilization Review RN On call/Per diem The Utilization Review (UR) Nurse has a strong clinical background blended with a 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...
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Physician Review/Utilization Review Physician
2 months ago
San Diego, CA, United States Vivo HealthStaff Full timeVivo HealthStaff is searching for a Physician for a health plan based in San Diego, CA. This is a full-time position with competitive benefits. The Physician Reviewer will perform all reasonably necessary functions to ensure the quality of care and appropriate utilization in the most cost-effective, appropriate, and professional manner, which meets the...
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Utilization Review Coordinator
2 weeks ago
Phoenix, AZ, United States Neuropsychiatric Hospitals Full timeAbout Us:HEALING THE BODY AND MINDFounded fifteen (15) years ago, NeuroPsychiatric Hospital is the largest hospital system in the nation providing care to patients with both neurological and medical needs. We are unique in that we serve a population which others have been previously been unable to, largely due the patient’s underlying medial issues. Our...
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Utilization Review RN
2 weeks ago
Everett, WA, United States Providence Full timeDescription Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial appeals where appropriate either during admission or post discharge. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Regional Medical Center Everett...
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Utilization Review RN
1 month ago
Everett, WA, United States Providence Full timeDescription Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial appeals where appropriate either during admission or post discharge. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Regional Medical Center Everett...
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Nurse Manager Utilization Review
5 days ago
Oswego, NY, United States Clinical Management Consultants Full timeAn 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...
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, TX, United States Other Executive Full timeJob SummaryWe are seeking an experienced Senior Director to lead our Utilization Review and Optimization efforts. This key leadership role will be responsible for developing and implementing strategies to improve the efficiency and effectiveness of our utilization review processes.Key ResponsibilitiesLead Utilization Review Teams: Oversee the development and...
Utilization Review
1 month ago
Details * Department: Utilization Review * Schedule: Varied - PRN * Hospital: Ascension St. Vincent's Riverside Hospital * Location: Jacksonville, FL Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community * Please note, benefits and benefits eligibility can vary by position, exclusions may apply for some roles (for example: Travel, PRN, Short-Term Option, etc.). Actual compensation offer will vary based upon role, education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics. Responsibilities Provide health care services regarding admissions, case management, discharge planning and utilization review. * Review admissions and service requests within assigned unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement policy criteria. * Provide case management and/or consultation for complex cases. * Assist departmental staff with issues related to coding, medical records/documentation, precertification, reimbursement and claim denials/appeals. * Assess and coordinate discharge planning needs with healthcare team members. * May prepare statistical analysis and utilization review reports as necessary. * Oversee and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. Requirements Licensure / Certification / Registration: * Licensed Registered Nurse obtained prior to hire date or job transfer date. Licensed as a Registered Nurse in Florida. Credentialed from State Board of Nursing or current home state license for multi-state license recognition "Compact State" obtained prior to hire date or job transfer date required. Education: * Diploma from an accredited school/college of nursing OR Required professional licensure at time of hire required. Additional Preferences No additional preferences. Why Join Our Team Ascension St. Vincent's is expanding in the fastest-growing county in Northeast Florida with the addition of a fourth regional hospital, Ascension St. Vincent's St. Johns County. Serving Northeast Florida and Southeast Georgia, Ascension St. Vincent's has been providing caregivers in every discipline a rewarding career in healthcare since 1873. Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states. Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you. Equal Employment Opportunity Employer Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster. As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension. Pay Non-Discrimination Notice Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants. E-Verify Statement This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information. E-Verify
