Utilization Review Nurse
2 weeks ago
Are you a LPN or an RN with Utilization Review experience? We are hiring for a Utilization Review Nurse in Washington, D.C This is a great opportuntiy to work with a leading healthcare organization in the DMV Details are outlined below, interviews are actively going on, apply today
Overview
- Day to day
- Health plan experience
- Hospital experience
- Interqual is preferred. Miliman works as well.
- Experience in health plans reviews (dermal medicine, home health, rehab)
- Pediatric inpatient admissions is a plus
- Authorization, long term care, skilled nursing, behavioral analysis would be a plus.
- Training in person. After training, the obligation is one day per week in the office based on the employees decision to select.
- Looking at 15 cases a day.
- Patient population - case load
- Pediatrics as well as adults from 18-25
- Can often see cerebral palsy, genetic issues, cancer, behavioral health (bipolar), substance abuse, will often be UR for Admissions with children's
Required Skills
-RN or LPN with experience
-UR in a health plan/insurance
-Interqual or Miliman experience
Nice to Have Skills
-Self motivated
-Productive
-Communication skills
Schedule
Monday through Friday 8:00AM-5:00PM
Pay Rate: $40.00-$46.00
Medix is acting as an Employment Agency in relation to this vacancy.
-
Utilization Review Nurse
17 hours ago
Washington, United States Medix Full timeUtilization Review Nurse Are you a LPN or an RN licensed in Washington, D.C. with Utilization Review experience? We are hiring for a Fully Remote Utilization Review Nurse to work with a leading healthcare organization in the DMV! Details are outlined below, interviews are actively going on, apply today!! Overview Ensure that patients receive the right...
-
Nursing Utilization Review Specialist
7 days ago
Washington, United States MedStar Health Full timeAbout the Role:We are seeking a skilled Nursing Utilization Review Specialist to join our team at MedStar Health. In this role, you will play a critical part in ensuring high-quality patient care by conducting admission, concurrent, and retrospective case reviews.Job Summary:The Nursing Utilization Review Specialist conducts thorough reviews of patients'...
-
RN Utilization Review
4 weeks ago
Washington, United States Medstar Full timeConducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.\r Education Associate's degree in Nursing required Bachelor's...
-
Utilization Review RN
1 week ago
Washington, United States Norman Regional Health System Full timeOverview: 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...
-
Utilization Review RN
2 weeks ago
Washington, United States Norman Regional Health System Full timeOverview: 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...
-
Utilization Review RN
2 weeks ago
Washington, United States Norman Regional Health System Full timeOverview: 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 EducationClinical Analysis and Data ManagementClinical Care...
-
Registered Nurse
3 weeks ago
Washington, United States MEDSTAR HEALTH Full timeConducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's degree...
-
Registered Nurse
3 weeks ago
Washington, United States MEDSTAR HEALTH Full timeConducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's degree...
-
Registered Nurse
3 weeks ago
Washington, United States MEDSTAR HEALTH Full timeConducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's degree...
-
Registered Nurse
3 weeks ago
Washington, United States MEDSTAR HEALTH Full timeConducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's degree...
-
Utilization Review RN
2 weeks ago
Washington, OK, United States Norman Regional Health System Full timeOverview: 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...
-
Healthcare Utilization Review Specialist
6 days ago
Washington, United States Medix™ Full timeAbout the RoleMedix is seeking a skilled and experienced Utilization Review Nurse to join our team. This role requires strong clinical knowledge, excellent communication skills, and the ability to work independently in a fast-paced environment.Job SummaryWe are looking for a dedicated RN with experience in utilization review, particularly in health plans and...
-
Utilization Review Nurse
7 days ago
Washington, United States Medix Full timeOverview of Utilization Review Nurse RoleWe are seeking an experienced Utilization Review Nurse to join our team in Washington, D.C.This is a great opportunity to work with a leading healthcare organization in the DMV, leveraging your expertise in health plan reviews and utilization management.Responsibilities:Conduct daily health plan reviews, ensuring...
-
Registered Nurse
3 weeks ago
Washington DC, United States MEDSTAR HEALTH Full timeConducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way. Education Associate's degree in Nursing required Bachelor's...
-
RN Utilization Review
3 months ago
Washington, United States MEDSTAR HEALTH Full timeGeneral Summary of PositionConducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way. Primary Duties and...
-
Registered Nurse
3 weeks ago
Washington DC, United States MEDSTAR HEALTH Full timeConducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way. Education Associate's degree in Nursing required ...
-
Utilization Review RN
2 weeks ago
Washington, OK, United States Norman Regional Health System Full timeOverview: 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 EducationClinical Analysis and Data ManagementClinical Care...
-
Registered Nurse
3 weeks ago
Washington, DC, United States MEDSTAR HEALTH Full timeConducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's degree...
-
Healthcare Travel Nurse
5 days ago
Washington, United States Medical Solutions Full timeAbout This OpportunityWe're seeking a skilled Utilization Review specialist to join our team as a Travel Nurse RN in Washington, District of Columbia.This 13-week contract offers a unique opportunity for healthcare professionals to showcase their expertise and dedication while exploring new horizons. As a key member of our team, you'll work closely with...
-
Medstar Utilization Review Specialist
4 days ago
Washington, Washington, D.C., United States Medstar Full timeJob OverviewWe are seeking a highly skilled Utilization Review Specialist to join our team at Medstar. In this role, you will play a crucial part in ensuring high-quality patient care by conducting thorough reviews of medical records.