Utilization Review Nurse
3 weeks ago
Hines & Associates Inc is a nationwide, independent leader in personalized managed healthcare, focused on delivering comprehensive services with program excellence and cost containment. With over three decades of innovative and professional healthcare excellence, Hines is committed to conserving healthcare dollars while ensuring quality care through effective programs and personalized service.
Job SummaryWe are seeking a skilled and experienced Registered Nurse to join our team as a Utilization Review Nurse. As a Utilization Review Nurse, you will utilize your clinical knowledge and communication skills to obtain patient-specific information regarding patient condition and proposed treatments and procedures to determine if illness and/or proposed services meet acceptable criteria sets and acceptable nursing practice guidelines for outpatient treatment or inpatient confinement.
Responsibilities- Completes first-level reviews within the scope of practice relevant to the clinical area(s) addressed in the initial clinical review.
- Demonstrates ability to assess a patient's current medical status, including complications and untoward events, which may require additional intervention.
- Provides certification of medical, disability, and workers' compensation cases.
- Evaluates appropriateness of current plan of care.
- Assesses aftercare needs, implements discharge planning, and/or case management referral in a timely manner.
- Registered Nurse with valid, unrestricted, current nursing license in the state or territory of the United States where employed.
- Successful completion of UR nurse orientation program.
- Minimum of 3 years recent acute clinical practice required, 5 years preferred.
- Competitive salary and benefits, including medical, dental, vision, long-term care, short-term disability, long-term disability, and company-paid life insurance.
- 401k plan with company match, fully vested after 1 year.
- No weekends and nights.
- Paid Holidays.
- Work-life balance.
- Remote/hybrid setting (once trained).
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Utilization Review Nurse
3 weeks ago
Rockford, Illinois, United States Hines & Associates Inc Full timeAbout UsHines & Associates Inc. is a nationwide leader in personalized managed healthcare, dedicated to delivering comprehensive services with excellence and cost containment.Job SummaryWe are seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will utilize your clinical knowledge and communication skills to review...
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Utilization Review Nurse
2 weeks ago
Rockford, Illinois, United States Hines & Associates Inc Full timeJob DescriptionHines & Associates Inc. is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the necessary medical care while minimizing costs.About the Role:This position involves reviewing patient medical records to determine the medical necessity of...
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Utilization Review Nurse
3 weeks ago
Rockford, Illinois, United States Hines & Associates Inc Full timeAbout Hines & Associates Inc.Hines & Associates Inc. is a nationwide, independent leader in personalized managed health care, focused on delivering comprehensive services with program excellence and cost containment. With over three decades of innovative and professional health care excellence, Hines has established a reputation as an industry leader.Our...
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Clinical Utilization Review Nurse
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Rockford, Illinois, United States Hines & Associates Inc Full timeAbout Hines & Associates Inc.Hines & Associates Inc. is a nationwide, independent leader in personalized managed health care, focused on what's important to you—comprehensive services with the program excellence and cost containment that you demand.Job Summary:We are seeking a skilled Clinical Utilization Review Nurse to join our team. As a Clinical...
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Clinical Utilization Review Nurse
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Rockford, Illinois, United States Hines and Associates Full timeAbout the Role:Nurses looking for a change can consider this opportunity with Hines and Associates. The position offers a Monday to Friday schedule, 9:30 AM to 6:00 PM, with the possibility of working from home 50% of the time once trained. About Us:Hines and Associates is a nationwide, independent leader in personalized managed health care. With over three...
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