Current jobs related to Utilization Review RN - Clackamas OR United States - Providence RN


  • Wellston, OK, United States Norman Regional Health System Full time

    Overview: The Utilization Review team is comprised of highly skilled Registered Nurses who ensure Norman Regional Health System follows a compliant review process to determine appropriateness of admission. Responsibilities: Job Summary Utilization Review, Utilization Management, Advocacy and Education Clinical Analysis and Data Management Clinical Care...

  • Utilization Review RN

    2 weeks ago


    Purcell, OK, United States Norman Regional Health System Full time

    Overview: The Utilization Review team is comprised of highly skilled Registered Nurses who ensure Norman Regional Health System follows a compliant review process to determine appropriateness of admission. Responsibilities: Job SummaryUtilization Review, Utilization Management, Advocacy and EducationClinical Analysis and Data ManagementClinical Care...


  • Columbus, OH, United States Mount Carmel Health System Full time

    Employment Type:Part timeShift:Description:Utilization Review RN, Case ManagementWhy Mount Carmel?              With five hospitals, over 60 free-standing outpatient clinics, a college of nursing, a Medicare Advantage plan, and extensive outreach and community wellness programs, Mount Carmel Health System serves more than a million patients in...


  • Nashville, TN, United States Ascension Full time

    Details Department: Case Management Schedule: Full-Time, Monday-Friday (8:00A - 4:30P) Hospital: Ascension St Thomas Location: Nashville, TN - - - ****TN Nursing License is REQUIREDBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee...


  • Brookhaven, GA, United States Children's Healthcare of Atlanta Full time

    Job DescriptionNote: If you are CURRENTLY employed at Children's and/or have an active badge or network access, STOP here. Submit your application via Workday using the Career App (Find Jobs).Work ShiftDayWork Day(s)Monday-Friday, VariableShift Start Time8:00 AMShift End Time4:00 PMWorker Sub-TypePRNChildren’s is one of the nation’s leading children’s...


  • Brookhaven, GA, United States Children's Healthcare of Atlanta Full time

    Job DescriptionNote: If you are CURRENTLY employed at Children's and/or have an active badge or network access, STOP here. Submit your application via Workday using the Career App (Find Jobs).Work ShiftDayWork Day(s)Monday-Friday, VariableShift Start Time8:00 AMShift End Time4:00 PMWorker Sub-TypePRNChildren’s is one of the nation’s leading children’s...


  • Nashville, TN, United States Ascension Full time

    Details Department: Case ManagementSchedule: Full-Time, Monday-Friday (8:00A - 4:30P)Hospital: Ascension St ThomasLocation: Nashville, TN ****TN Nursing License is REQUIREDBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance...


  • Winston-Salem, NC, United States Novant Health Full time

    OverviewThe 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...


  • Winston Salem, NC, United States Novant Health Full time

    Overview 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...

  • Utilization Review RN

    3 weeks ago


    Apple Valley, CA, United States Providence Full time

    Description 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,...


  • Brookhaven, GA, United States Children's Healthcare of Atlanta Full time

    Job DescriptionNote: If you are CURRENTLY employed at Children's and/or have an active badge or network access, STOP here. Submit your application via Workday using the Career App (Find Jobs).Work ShiftVariableWork Day(s)VariableShift Start Time8:00 AMShift End Time4:00 PMWorker Sub-TypePRNChildren’s is one of the nation’s leading children’s hospitals....


  • Miami, FL, United States Centene Corporation Full time

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. ***POSITION IS REMOTE BUT CANDIDATE MUST RESIDE IN STATE OF FLORIDA***Position...


  • Trenton, NJ, United States Capital Health (US) Full time

    Job DescriptionWork ShiftCapital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advance technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical...


  • Pompano Beach, FL, United States Centene Corporation Full time

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. ***POSITION IS REMOTE BUT CANDIDATE MUST RESIDE IN STATE OF FLORIDA***Position...

  • Navigator RN

    5 days ago


    Clackamas, OR, United States Providence RN Full time

    Description The Outpatient Infusion RN Navigator (OPI-RNN) serves as a consistent resource throughout the continuum of infusion therapies. This RN is knowledgeable of the multiple treatment therapies and modalities, has strong background on EPIC/BEACON utilization, and is familiar with the financial aspects of the infusion therapies. The OPI-RNN...

  • Navigator RN

    4 days ago


    Clackamas, OR, United States Providence RN Full time

    Description The Outpatient Infusion RN Navigator (OPI-RNN) serves as a consistent resource throughout the continuum of infusion therapies. This RN is knowledgeable of the multiple treatment therapies and modalities, has strong background on EPIC/BEACON utilization, and is familiar with the financial aspects of the infusion therapies. The OPI-RNN...


  • Chicago, IL, United States HireOps Staffing LLC Full time

    Nurse Liaison I UM & QR Contract to hire, $41/hour, 5 days onsite in Chicago or Naperville. BASIC FUNCTION: This position is responsible for ensuring compliance with the Utilization Management (UM) and Quality Review (QR) functions performed by the Medical Groups/IPAs participating. Evaluates the need for, designs, and implements educational seminars for...


  • Crowley, LA, United States Centene Full time

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Louisiana Licensure is Required as One of the Following:LCSW- License Clinical...


  • Washington, DC, United States MEDSTAR HEALTH Full time

    Job 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...


  • Omaha, NE, United States Centene Full time

    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Performs a clinical review and assesses care related to...

Utilization Review RN

2 months ago


Clackamas OR United States Providence RN Full time

Description

The 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 the multiple disciplines, both internal and external to the organization, in effecting quality and cost-effective management of the patient care along the continuum.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Oregon Regional Shared Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required Qualifications:

  • Bachelor's Degree - Nursing or, associates Degree and 2+ years of related experience in lieu of a Bachelor's Degree.
  • Oregon Registered Nurse License upon hire.
  • 5 years:
  • Clinical experience in an acute adult medical/surgical care setting . Or,
  • Current Utilization Review or Case Management experience.
  • Demonstrated clinical expertise and experience related to a wide variety of patient populations and care delivery models.

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

About the Team

Providence has been serving the Pacific Northwest since 1856 when Mother Joseph of the Sacred Heart and four other Sisters of Providence arrived in Vancouver, Washington Territory. As the largest healthcare system and largest private employer in Oregon, Providence is located in areas ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland.

Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 314738

Company: Providence Jobs

Job Category: Health Information Management

Job Function: Revenue Cycle

Job Schedule: Full time

Job Shift: Day

Career Track: Nursing

Department: 5016 RS UTILIZATION MGMT

Address: OR Portland 9205 SW Barnes Rd

Work Location: Providence St Vincent Medical Ctr-Portland

Pay Range: $45.22 - $71.58

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

PandoLogic. Category:Healthcare, Keywords:Utilization Review Coordinator, Location:Clackamas, OR-97015