Utilization Review Nurse
2 weeks ago
HEALING THE BODY AND MIND
Founded 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 facilities maintain an inter-disciplinary focus using a multi-specialty approach for both neuropsychiatric and complex medical care issues. This proven approach provides unrivaled quality care for all of our patients. We have multiple locations throughout the United States and are continuing to add locations to ensure better access to our unique model of care.
Overview:
Neuropsychiatric Hospitals is looking for a Utilization Review Nurse (RN) to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with multidisciplinary teams. This will provide service to our utilization review team at our Bremen location.
Benefits of joining NPH
Competitive pay rates
Medical, Dental, and Vision Insurance
NPH 401(k) plan with up to 4% Company match
Employee Assistance Program (EAP) Programs
Generous PTO and Time Off Policy
Special tuition offers through Capella University
Work/life balance with great professional growth opportunities
Employee Discounts through LifeMart
Responsibilities:
Filing documents as needed.
Initial Precertification with payors.
Concurrent Clinical review with payors.
Document in the electronic system daily in real time.
Admission audit.
Ensures that CON’s/RON’s and CMS certifications are completed by provider.
Consistently demonstrates professionalism with all internal and external customers as evidenced by positive customer and peer Communicates effectively with all staff and patients as evidenced by the establishment and maintenance of productive working relationships.
Maintains knowledge of current trends and developments in the field by reading appropriate books; journals and other literature and attending related seminars or conferences.
Maintains a professional approach with Assures protection and privacy of health information as attained through written, electronic or oral disclosures.
Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital polices that apply.
Complies with hospital expectations regarding ethical behavior and standards of conduct.
Complies with federal and hospital requirements in the areas of protected health information and patient information.
Reconsiderations, assists with appeals as needed, arrange peer to peer level reviews, and report the outcomes to the VP of Care Management and Team.
Provides education to nursing staff. leadership team, and providers regarding documentation.
Actively works with the business office regarding resolution of appeals/denials and retrospective reviews.
Qualifications:
Education: Must have graduated from an accredited school of nursing.
Licensure: Registered Nurse (RN) or Licensed Practical Nurse (LPN) in the state of Indiana required
Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.
Job Type: Full-time
-
Utilization Review Nurse
1 month ago
Bremen, United States NeuroPsychiatric Hospitals Full timeAbout UsHEALING THE BODY AND MIND Founded 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...
-
Utilization Review Nurse
5 days ago
Bremen, United States NeuroPsychiatric Hospitals Full timeAbout Us: HEALING THE BODY AND MIND Founded 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 patients underlying medial issues. Our...
-
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...
-
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...
-
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...
-
Utilization Review Coordinator
2 weeks ago
Crown Point, 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...
-
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...
-
Nurse Manager Utilization Review
5 days ago
Westwood, NJ, United States Clinical Management Consultants Full timeA leading acute care hospital located in southeastern New York is now searching for an experienced Nurse Manager Utilization Review to join their award-winning healthcare team. This acute care facility was founded over one hundred years ago and today houses nearly 400 licensed beds and offers a wide variety of medical and surgical services. This...
-
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...
-
Nurse Director Utilization Review
5 days ago
Brockton, MA, United States Clinical Management Consultants Full timeA leading acute care hospital located in eastern Massachusetts is now searching for an experienced Nurse Director Utilization Review to join their award-winning healthcare team This not-for-profit acute care hospital is a respected healthcare facility with a long-standing history of providing a range of quality medical services to the local community....
-
Registered Nurse
1 month ago
Overland Park, KS, United States Wellsky Full timeThe Utilization Review Nurse performs prospective and retrospective reviews for post-acute care services. The purpose and goal of utilization management is to assure that Wellsky’s population receives medically necessary services in the appropriate setting, with the appropriate provider, and at the appropriate level of care. This position is responsible...
-
Registered Nurse Utilization Review Specialist
21 hours ago
, TX, United States University of Texas Southwestern Medical Center Full timeJob SummaryAs a Registered Nurse Utilization Review Specialist at the University of Texas Southwestern Medical Center, you will play a critical role in ensuring the delivery of high-quality, cost-effective patient care. Your expertise will be utilized to conduct medical necessity reviews for acute care services, utilizing evidence-based guidelines to...
-
Licensed Practical Nurse
2 weeks ago
Fontana, CA, United States Pyramid Consulting Full timePyramid Consulting is looking for a dedicated Licensed Practical Nurse (LPN) / Licensed Vocational Nurse (LVN) to join our team for a local contract role focused on Utilization Review.Position OverviewThe successful candidate will be responsible for:Specialty: Utilization ReviewDiscipline: LPN / LVNWork Schedule: 40 hours per weekShift: 8 hours,...
-
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...
-
RN - Utilization Review
25 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...
-
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...
-
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...
-
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...
-
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...
-
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...
