Clinical Utilization Review Nurse

3 weeks ago


Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time
Job Summary

We are seeking a skilled Clinical Utilization Review Nurse to join our team at the University of New Mexico - Hospitals. As a key member of our Utilization Management department, you will play a critical role in ensuring that patients receive high-quality, cost-effective care.

Key Responsibilities
  • Conduct thorough assessments of patient cases to determine medical necessity and develop comprehensive care plans.
  • Collaborate with healthcare teams to ensure seamless coordination of care and effective resource utilization.
  • Monitor and analyze patient outcomes to identify areas for quality improvement and implement evidence-based solutions.
  • Develop and maintain strong relationships with patients, families, and healthcare providers to ensure patient-centered care.
  • Stay up-to-date with industry trends, best practices, and regulatory requirements to ensure compliance and excellence in care delivery.
Requirements
  • 1 year of experience in clinical utilization review or a related field.
  • Current RN licensure in New Mexico or eligibility for reciprocal agreement.
  • CPR for Healthcare/BLS certification within 30 days.
  • Excellent communication, critical thinking, and problem-solving skills.
What We Offer
  • A dynamic and supportive work environment.
  • Opportunities for professional growth and development.
  • A competitive salary and benefits package.


  • Rio Rancho, New Mexico, United States HireOps Staffing LLC Full time

    HEDIS Review Nurse Job DescriptionThis is a contracted position that will involve working with medical records to ensure compliance with standards of patient care set forth by insurance companies. The ideal candidate will have experience with medical record review and be able to apply structured auditing criteria to abstract medical records.Key...


  • Rio Rancho, New Mexico, United States HireOps Staffing LLC Full time

    HEDIS Review Nurse Job DescriptionThis is a contracted position that will start on a specific date to a specific date. Manager is seeking candidates in a specific state.A RN or LPN/LVN responsible for annual patient chart inspection/audit. Audits are conducted to ensure that providers (MDs) accepting insurance are in compliance with standards of patient care...


  • Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job SummaryWe are seeking a highly skilled and compassionate Registered Nurse to join our team at the University of New Mexico - Hospitals. As a key member of our nursing staff, you will provide direct patient care, lead clinical teams, and contribute to the development of our Clinical Advancement Program.ResponsibilitiesProvide direct patient care to...


  • Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job SummaryWe are seeking a highly skilled and dedicated Registered Nurse to join our Intensive Care Unit (ICU) team at UNM Hospitals. As a key member of our healthcare team, you will provide direct patient care, lead clinical teams, and contribute to the development of our nursing staff.ResponsibilitiesProvide direct patient care to assigned patients,...


  • Rio Rancho, New Mexico, United States UNM Medical Group Full time

    Job SummaryUNM Medical Group is seeking a highly skilled and experienced Registered Nurse to fill the role of Supervisor, Registered Nurse - Outpatient Clinic. This is a full-time position located in Rio Rancho, New Mexico, and offers a competitive salary and comprehensive benefits package.Key ResponsibilitiesSupervise and coordinate the activities of...


  • Rio Rancho, New Mexico, United States University of New Mexico Full time

    Job Title: Clinical NurseWe are seeking a compassionate and skilled Clinical Nurse to join our team in the PreOp/PACU department at the University of New Mexico.About the Role:As a Clinical Nurse, you will provide direct nursing care to patients, including Neonates, Pediatrics, Adolescents, Adults, and Geriatric age groups. You will also serve as a clinical...

  • Clinical Nurse Leader

    3 weeks ago


    Rio Rancho, New Mexico, United States University of New Mexico Full time

    Clinical Nurse Leader Job DescriptionA hospital in New Mexico is seeking an experienced Clinical Nurse Leader to provide high-quality patient care.Key Responsibilities:Collaborate with interdisciplinary healthcare teams to develop personalized care plans for patientsSupervise and lead nursing teams in delivering exceptional patient careMonitor and assess...


  • Rio Rancho, New Mexico, United States University of New Mexico Full time

    Job SummaryWe are seeking a dedicated Registered Nurse to provide safe and direct patient care in our outpatient clinic. As a key member of our team, you will provide clinical leadership and mentorship to staff, as well as full patient education to patients and their families.ResponsibilitiesFollow patient safety-related policies, procedures, and...


  • Rio Rancho, New Mexico, United States University of New Mexico Full time

    Clinical Nurse Job DescriptionWe are seeking a skilled and compassionate Clinical Nurse to join our team in the PreOp/PACU department at the University of New Mexico.Key Responsibilities:Provide direct nursing care to patients across various age groups, including Neonates, Pediatrics, Adolescents, Adults, and Geriatric patients.Administer medication,...


  • Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job SummaryWe are seeking a highly skilled Registered Nurse to join our team at the University of New Mexico - Hospitals. As a member of our Clinical Advancement Program, you will have the opportunity to advance your nursing career and increase your compensation based on your education and national certifications.Key ResponsibilitiesProvide direct nursing...


  • Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job SummaryWe are seeking a highly skilled and compassionate Registered Nurse to join our team at UNM Hospitals. As an Ambulatory Clinic Nurse, you will provide direct nursing care to patients in a fast-paced and dynamic environment.Key ResponsibilitiesWork within the nursing process to provide direct nursing care to assigned patients.Provide clinical...


  • Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job SummaryWe are seeking a highly skilled and compassionate Registered Nurse to join our team at the University of New Mexico - Hospitals. As an Ambulatory Clinic Nurse, you will provide direct nursing care to patients in a variety of settings, including clinics and outpatient departments.Key ResponsibilitiesProvide high-quality patient care, including...


  • Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job SummaryWe are seeking a highly skilled and compassionate Registered Nurse to join our team at the University of New Mexico - Hospitals. As an Ambulatory Clinic Nurse, you will provide direct nursing care to assigned patients, working within the nursing process to ensure the highest level of patient satisfaction and care.Key ResponsibilitiesProvide...


  • Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job SummaryWe are seeking a highly skilled and compassionate Registered Nurse to join our team at UNM Hospitals. As an Ambulatory Clinic Nurse, you will provide direct nursing care to patients in a fast-paced and dynamic environment.Key ResponsibilitiesProvide clinical leadership and assume relief charge duties when designatedWork within the nursing process...


  • Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job SummaryWe are seeking a highly skilled and compassionate Registered Nurse to join our team at UNM Hospitals. As an Ambulatory Clinic Nurse, you will provide direct nursing care to assigned patients, work within the nursing process to ensure high-quality patient outcomes, and serve as a clinical leader for other staff members.Key ResponsibilitiesProvide...


  • Rio Rancho, New Mexico, United States University of New Mexico Full time

    Clinical Nurse Leader Job DescriptionA hospital located in New Mexico is seeking an experienced Clinical Nurse Leader to provide direct nursing care to their patients.This position requires the candidate to work in various healthcare settings with diverse patients. If you are a passionate leader with a degree in nursing and expertise in the field, we...


  • Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job SummaryWe are seeking a highly skilled and dedicated Registered Nurse to join our team at UNM Hospitals. As an Ambulatory Clinic Nurse, you will provide direct nursing care to assigned patients, work within the nursing process to ensure high-quality patient care, and serve as a role model to promote a positive work environment.ResponsibilitiesProvide...


  • Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job SummaryWe are seeking a highly skilled and compassionate Registered Nurse to join our team at the University of New Mexico - Hospitals. As an Ambulatory Clinic Nurse, you will provide direct nursing care to patients in a variety of settings, including clinics and outpatient departments.Key ResponsibilitiesProvide high-quality patient care, including...


  • Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job SummaryWe are seeking a highly skilled and experienced Registered Nurse to join our Intensive Care Unit (ICU) team at the University of New Mexico - Hospitals. As a key member of our clinical team, you will be responsible for providing high-quality patient care, leading by example, and promoting a positive work environment.Key ResponsibilitiesProvide...


  • Rio Rancho, New Mexico, United States University of New Mexico Full time

    Clinical Nurse Educator OpportunityWe are seeking a highly skilled Clinical Nurse Educator to provide safe direct care to patients on the Inpatient 5th Floor. As a key member of our team, you will be responsible for facilitating evidenced-based research and national standards into specialized areas of nursing.Key Responsibilities:Develop and implement...