RN-Utilization Review PRN
3 days ago
Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness, and/or life situation. Performs other duties as assigned.
Responsibilities:
- Utilization Review
- Discharge planning
- Readmission Reduction Participation
- Payer Communication and denial reduction
- Completes assigned goals.
Experience:
Minimum Required:
- RN with at least one (1) year of clinical experience
Preferred/Desired:
- RN with 3 years of clinical experience with Case Management experience in a hospital or payer setting
Education:
Minimum Required:
- Diploma or Associate Degree in Nursing
Preferred/Desired:
- BSN or MSN
Training:
Minimum Required:
Preferred/Desired:
- Certified Case Manager
Special Skills:
Minimum Required:
- Critical thinking skills, communication, organization, interpersonal and computer skills. Problem solving; and governmental regulations.
Preferred/Desired:
- Critical thinking skills, communication, organization, interpersonal and computer skills. Knowledge of payer requirements; problem solving; and governmental regulations.
Licensure:
Minimum Required:
- RN
Preferred/Desired:
- RN;CCM;ACM
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Memphis, TN, United States Baptist Memorial Healthcare Corporation Full timeOverview Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance companies and patients to ensure cost-effective and appropriate care. Areas of work include status management,...
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RN-Utilization Review PRN
1 week ago
Memphis, TN, United States Baptist Memorial Healthcare Corporation Full timeOverview Job Summary Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness,...
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RN-Utilization Review PRN
7 days ago
Memphis, TN, United States Baptist Memorial Healthcare Corporation Full timeOverview Job Summary Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness,...
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RN-Utilization Review PRN
5 days ago
Memphis, TN, United States Baptist Memorial Healthcare Corporation Full timeOverview Job Summary Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness,...
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RN Utilization Review
7 days ago
Memphis, TN, United States Baptist Memorial Healthcare Corporation Full timeOverview Job Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance companies and patients to ensure cost-effective and appropriate care. Areas of work include status...
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RN Utilization Review
5 days ago
Memphis, TN, United States Baptist Memorial Healthcare Corporation Full timeOverview Job Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance companies and patients to ensure cost-effective and appropriate care. Areas of work include status...
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RN-Utilization Review Part Time
1 week ago
Memphis, TN, United States Baptist Memorial Health Full timeSummary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance companies and patients to ensure cost-effective and appropriate care. Areas of work include status management, medical...
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RN-Utilization Review Part Time
3 days ago
Memphis, TN, United States Baptist Memorial Healthcare Corporation Full timeOverview Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance companies and patients to ensure cost-effective and appropriate care. Areas of work include status management,...
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RN-Utilization Review Part Time
3 days ago
Memphis, TN, United States Baptist Memorial Health Full timeSummary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance companies and patients to ensure cost-effective and appropriate care. Areas of work include status management, medical...
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RN-Utilization Review Part Time
1 week ago
Memphis, TN, United States Baptist Memorial Healthcare Corporation Full timeOverview Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance companies and patients to ensure cost-effective and appropriate care. Areas of work include status management,...