Utilization Review RN
2 weeks ago
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: Utilization Review, Utilization Management, Advocacy and Education Clinical Analysis and Data Management Clinical Care Management/Coordination Resource Management Transition Management and Denial Prevention Utilization Management Psychosocial Management Assist with establishing and review of departmental metrics on annual basis or as needed to insure mission, vision and strategic plan of NRHS. Qualifications: Education Diploma or Associate’s degree (ADN) required, Bachelor of Science in Nursing (BSN), or Master's of Science in Nursing (MSN) preferred. Experience 3 years of acute RN experience required. Prior Utilization Review experience preferred. Current knowledge of medical necessity guidelines for hospitalization status preferred. (Above requirements can be met by equivalent combination of education and experience) Licensure/Certification Current, RN license in the state of Oklahoma, Basic Life Support (BLS) training or retraining is required and must be maintained for the duration of employment. Compensation/Benefits $17.39-$28.40/hr depending on previous work experience. Benefits include medical, dental, vision, short-term disability, long-term disability, life insurance, paid time off (PTO), paid holidays, tuition reimbursement, scholarship opportunities, retirement plans, free parking, and opportunities for advancement. Utilization Review RN - Nights at Norman Regional Health System summary: The Utilization Review RN specializes in evaluating the appropriateness of patient admissions within the healthcare system. With a focus on clinical care management, resource management, and advocacy, this role ensures compliance with medical necessity guidelines while coordinating patient resources. The position requires a minimum of three years of acute RN experience and emphasizes the importance of effective utilization management to prevent denials and enhance patient care. Keywords: Utilization Review, Registered Nurse, Healthcare Management, Clinical Analysis, Patient Care Coordination, Medical Necessity, Healthcare Compliance, Resource Management, Nursing, Acute Care
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Utilization Review RN
2 weeks ago
Mission Hills, United States Providence Full timeDescription Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care...
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Utilization Review RN
2 weeks ago
Mission Hills, United States Providence Full timeDescription Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused,...
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Utilization Review RN
2 days ago
Mission Hills, United States Providence Health & Service Full timeJob DescriptionResponsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members.Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care...
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Utilization Review Clinical Nurse Specialist
1 week ago
Mission Hills, Kansas, United States Providence Full timeJob SummaryWe are seeking a skilled Utilization Review RN to join our team at Providence Medical Foundation. This role is responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost-effective care to our members.About the RoleIn this position, you will be part of a comprehensive health...
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Utilization Review RN
2 weeks ago
Mission Hills, United States Providence Health & Service Full timeDescription Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care built...
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Utilization Review RN
2 weeks ago
Mission Hills, United States Providence Service Full timeDescription Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care...
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Utilization Review Clinical Specialist
1 week ago
Mission Hills, United States Providence Full timeAbout the Role:">We are seeking a highly skilled and experienced Utilization Review Nurse to join our team at Providence Medical Foundation. As a key member of our clinical network, you will play a critical role in promoting quality and cost-effective care for our patients.Key Responsibilities:">Provide utilization review and coordination of care throughout...
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Utilization Review RN Part-time/Days
2 weeks ago
Mission Hills, United States Providence Full timeDescription Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by the health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in Utilization Management,...
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Utilization Review RN Per Diem/Days
1 month ago
Mission Hills, United States Providence Full timeDescription Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by the health plans. This role requires a strong clinical background combined with well-developed knowledge and skills in Utilization Management,...
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Utilization Review RN
2 weeks ago
Mission Hills, CA, United States Providence Full timeDescription Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused,...
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Utilization Review RN
2 weeks ago
Mission Hills, CA, United States Providence Full timeDescription Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused,...
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Utilization Review RN
6 days ago
Mission Hills, CA, United States Providence Full timeDescription Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused,...
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Care Manager
6 days ago
Beverly Hills, California, United States Mass General Brigham Full timeAbout the RoleMass General Brigham seeks a skilled Care Manager to join their experienced Case Management team in Beverly, Massachusetts. This role focuses on transition planning and utilization review, ensuring seamless care delivery for patients.In this position, you will work closely with multidisciplinary teams to assess patient needs, develop...
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Utilization Review Nurse
1 week ago
Mission Hills, United States Providence Service Full timeJob OverviewWe are seeking a skilled Utilization Review Nurse to join our team at Providence Service. As a Utilization Review Nurse, you will play a crucial role in promoting quality and cost-effective care for our members.About the RoleThis is a full-time position, working day shifts. The salary for this role is $52.46 - $83.05 per hour, with additional...
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LVN / LPN/Utilization Review
1 month ago
Beverly Hills, United States Diverse Lynx Full time*** This position will travel to multiple clinics for incident management and staff training *** This position will be supervised and receive assignments from a remote RN Mileage reimbursement provided Schedule: Monday-Friday Shift: 0800-1700 Required: * 2+ Years of Ambulatory Care experience * CA LVN license * Driver's License and...
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LVN / LPN/Utilization Review
15 hours ago
Beverly Hills, United States Diverse Lynx Full time*** This position will travel to multiple clinics for incident management and staff training *** This position will be supervised and receive assignments from a remote RN Mileage reimbursement provided Schedule: Monday-Friday Shift: 0800-1700 Required: * 2+ Years of Ambulatory Care experience * CA LVN license * Driver's License and Auto...
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Registered Nurse
2 weeks ago
Nichols Hills, United States Norman Regional Health System Full timeOverview: Norman Regional Health System's Intermediate Care (IMC) staff cares for a wide variety of patients with complex medical conditions requiring intermediate or critical care. NRHS is an accredited primary stroke center and the Intermediate Care is our dedicated stroke unit for the health system. Our team is award winning (Women's Choice award...
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Registered Nurse
2 weeks ago
Nichols Hills, United States Norman Regional Health System Full timeOverview: Norman Regional Health System's Intermediate Care (IMC) staff cares for a wide variety of patients with complex medical conditions requiring intermediate or critical care. NRHS is an accredited primary stroke center and the Intermediate Care is our dedicated stroke unit for the health system. Our team is award winning (Women's Choice award...
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Registered Nurse
2 weeks ago
Nichols Hills, United States Norman Regional Health System Full timeOverview: Norman Regional Health System's Intermediate Care (IMC) staff cares for a wide variety of patients with complex medical conditions requiring intermediate or critical care. NRHS is an accredited primary stroke center and the Intermediate Care is our dedicated stroke unit for the health system. Our team is award winning (Women's Choice award...
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Registered Nurse
2 weeks ago
Nichols Hills, United States Norman Regional Health System Full timeOverview: Norman Regional Health System's Intermediate Care (IMC) staff cares for a wide variety of patients with complex medical conditions requiring intermediate or critical care. NRHS is an accredited primary stroke center and the Intermediate Care is our dedicated stroke unit for the health system. Our team is award winning (Women's Choice award...
