RN, Clinical Utilization Review Specialist

Job Summary:The RN Utilization Review Specialist is responsible for ensuring the clinical appropriateness of care provided to patients and optimizing hospital resource utilization. This role involves performing pre-admission, concurrent, and retrospective reviews to ensure compliance with regulatory requirements and industry standards. The RN Utilization...

Job SummaryThe RN Utilization Review Specialist is a key member of the healthcare team at Christus Health, responsible for ensuring the clinical appropriateness of care provided to patients and optimizing hospital resource utilization. This role involves performing pre-admission, concurrent, and retrospective reviews to ensure that patients receive the most...

Position Overview: The Registered Nurse - Utilization Review Specialist plays a crucial role in assessing the clinical necessity of patient care and optimizing the use of hospital resources. Key Responsibilities: Utilize established screening criteria such as InterQual, MCG, and CMS Inpatient List to evaluate patient care.Manage a varied workload effectively...

About the Role:The Clinical Utilization Specialist is responsible for conducting thorough reviews of assigned admissions, continued stays, and discharge planning to ensure compliance with established clinical criteria and regulatory requirements.Key Responsibilities:Perform admission, concurrent, continued stay, and retrospective reviews using established...

Clinical Recruitment SpecialistWe are seeking a highly skilled Clinical Recruitment Specialist to join our team at Worldwide Clinical Trials. As a key member of our recruitment team, you will play a critical role in advancing new medications from discovery to reality.About Our CompanyWorldwide Clinical Trials is a global, mid-size Contract Research...

Job SummaryThe Texas Department of Aging & Disability Services is seeking a highly skilled Nurse II - Utilization Review Specialist to join our team. As a key member of our Utilization Review team, you will play a critical role in ensuring that individuals served in our waiver programs and Community Attendant Services receive the appropriate type and amount...

Job Summary:The RN Utilization Review Specialist is responsible for ensuring the clinical appropriateness of care provided to patients and optimizing hospital resource utilization. This role involves performing pre-admission, concurrent, and retrospective reviews to ensure compliance with regulatory requirements and industry standards. The ideal candidate...

Position Overview The Clinical Review Nurse possesses advanced expertise in the domains of utilization management (UM), medical necessity assessments, and patient status evaluations. This role is integral to the UM program, focusing on the establishment and maintenance of effective processes for determining appropriate admission statuses in accordance with...

Job Title: Concurrent Review Nurse - RNJob Type: ContractLocation: RemoteJob Description:Job SummaryWe are seeking a highly skilled Concurrent Review Nurse - RN to join our team at Pyramid Consulting, Inc. As a Concurrent Review Nurse, you will be responsible for managing facilities for acute care in patient stays, conducting initial reviews, concurrent stay...

Job SummarySan Antonio Behavioral Health is seeking a highly skilled Utilization Review Coordinator to join our team. As a key member of our clinical operations team, you will play a critical role in ensuring the effective and efficient use of hospital services.Key ResponsibilitiesConduct Utilization Reviews: Conduct thorough reviews of patient charts and...

Job Title: Concurrent Review Nurse - RNJob Summary:We are seeking a skilled Concurrent Review Nurse - RN to join our team at Pyramid Consulting, Inc. As a key member of our healthcare industry client, you will be responsible for managing facilities for acute care in patient stays, conducting initial reviews, concurrent stay reviews, and discharges. This is a...

About ICON plc:ICON plc is a premier organization specializing in healthcare intelligence and clinical research. We are dedicated to advancing clinical research by providing outsourced services to pharmaceutical, biotechnology, medical device, and governmental organizations.With a patient-centric approach, we strive to expedite the development of medications...

Job SummaryThe Methodist Hospital Texsan is seeking a skilled RN Case Manager PRN to join our team. As a RN Case Manager PRN, you will work with patient/families to identify and address discharge planning, psychosocial, financial, or other needs.Key ResponsibilitiesAssess discharge needs of high-risk patients and identify resources to address those...

Job SummaryWe are seeking a highly skilled CLS Provider Utilization Coordinator Specialist to join our team at QTC Management, Inc. This role will be responsible for coordinating with clinic office managers and business partner agencies to maximize clinic capacity.Key ResponsibilitiesCommunication and Coordination: Consistently and effectively communicate...

Clinical Nurse Specialist - Summit Health, Inc About Our OrganizationSummit Health, Inc is a physician-led, patient-focused network dedicated to enhancing healthcare delivery and fostering a more integrated approach to patient care.Our diverse range of healthcare providers, including primary care, specialty, and urgent care professionals, serve a vast...

Overview of the Opportunity The Organization - KurzSolutions is dedicated to enhancing health outcomes by connecting well-managed organizations with the finest healthcare professionals available in the market. About the Role - Registered Nurse Case Manager As a Registered Nurse Case Manager, you will play a crucial role in the Case Management Program...

Overview:The Clinical Nurse Specialist operates independently within a healthcare environment, showcasing a comprehensive understanding of all pertinent factors in various scenarios. This role involves delivering both routine and intricate patient care, with an emphasis on long-term objectives. The nurse is equipped to manage unexpected situations in...

Job SummaryWe are seeking a highly skilled Clinical Pharmacist Specialist to join our team at Methodist Le Bonheur Healthcare. As a key member of our pharmacy department, you will be responsible for providing clinical expertise and leadership in the development and implementation of pharmacy services.Key ResponsibilitiesInterpret orders and transcribe or...

Position Overview Role Summary: The Clinical Nurse Specialist (CNS) evaluates, implements or delegates, organizes, and assesses comprehensive nursing care and operates in alignment with established principles, delivering and overseeing patient care for a designated group of individuals. The Clinical Nurse Specialist (CNS) collaborates effectively with...

Overview:The Senior Utilization Management Nurse plays a crucial role in assessing the clinical necessity of patient care and optimizing the use of hospital resources. This position involves conducting various pre-admission, concurrent, and retrospective reviews related to utilization management. The nurse is expected to proficiently apply established...