Jobs: utilization review nurse

As a Utilization Review Specialist, you will accurately and timely complete utilization review activitiesActively Communicate with interdisciplinary team members to acquire information and give updates on authorizationsEnsure all pre-certifications are completed for inpatient and outpatient servicesMonitor level of care LOS, report appropriatelyWork with...

As a Utilization Review Specialist, you will accurately and timely complete utilization review activitiesActively Communicate with interdisciplinary team members to acquire information and give updates on authorizationsEnsure all pre-certifications are completed for inpatient and outpatient servicesMonitor level of care LOS, report appropriatelyWork with...

**Job Summary:**At LifeBridge Health, we strive to provide exceptional care to our patients. As a Utilization Review Nurse, you will play a vital role in ensuring that our patients receive the best possible care. Your primary responsibility will be to conduct thorough clinical reviews of patient charts to assess clinical, financial, and resource utilization...

Case ManagementFull TimeDays8a-430pReq# 9554Complete utilization management functions for assigned patients as outlined in the Utilization Review Plan for Randolph Hospital. Review patient record and plan of care at admission or placement into observation utilizing the criteria set approved and adopted by the Medical Executive Committee. Facilitate any...

Nursing Utilization Reviewer RoleThe nursing utilization reviewer will utilize clinical knowledge and communication skills to review patient information. This includes assessing patient medical status, evaluating current plan of care, and providing certification of medical cases.Benefits and PerksCompetitive salary and benefits package.Work-life balance with...

Job SummaryWe are seeking a skilled Utilization Review Nurse to join our team. The ideal candidate will have strong communication and problem-solving skills, with the ability to work effectively in a fast-paced environment. As a Utilization Review Nurse, you will be responsible for reviewing patient admissions, identifying opportunities for optimization, and...

Carteret Health Care seeks a talented Utilization Review Nurse to join our team. As a key member of our Case Management department, this individual will be responsible for ensuring regulatory compliance with CMS Conditions of Participation with regard to Utilization Management.Key Responsibilities:Perform Utilization Review according to CMS...

Utilization Review Nurse - Psych RN ExperiencePosition Summary:Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment.Essential Functions: Chart ReviewReviews the medical record by applying utilization review...

About CarolinaEast Medical Center CarolinaEast Health System is dedicated to quality and compassionate care across the Coastal Carolina region. The flagship of the health system is a 350 bed full service medical center housing a complete complement of inpatient and outpatient services with the latest technology. CarolinaEast Health System employs 2,500...

Job DescriptionClinical Review Specialists work closely with healthcare providers and clients to ensure the delivery of high-quality care. As a Nurse Utilization Reviewer, you will perform clinical reviews according to established policies and procedures within identified timeframes.Key ResponsibilitiesConduct clinical reviews to determine medical...

The Utilization Review Nurse role supports managing a utilization review program through planning, data analysis, and goal setting to ensure entitled reimbursement and compliance with guidelines. Duties/Responsibilities: Actively supports utilization review services to obtain authorization for payment from 3rd party payers in preadmission, admission,...

per diem, 8a-430p, ASN/ WE + Occ/ Hol About Us Milford Regional Medical Center is a full-service, community and regional teaching hospital located in Milford, Mass. and serves patients from more than 20 towns in Central Massachusetts. The 149-bed medical center is a nonprofit, acute-care facility, where more than 300 primary care and specialty physicians...

per diem, 8a-430p, ASN/ WE + Occ/ HolAbout UsMilford Regional Medical Center is a full-service, community and regional teaching hospital located in Milford, Mass. and serves patients from more than 20 towns in Central Massachusetts. The 149-bed medical center is a nonprofit, acute-care facility, where more than 300 primary care and specialty physicians are...

Job Title: Clinical Nurse Liaison">Job Summary:">This role involves conducting utilization reviews, coordinating care transitions, and ensuring safe discharge processes for patients. The successful candidate will work collaboratively with healthcare professionals to improve patient outcomes and reduce readmissions.About the Role:">As a Clinical...

Job Summary:">We are seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will play a critical role in ensuring cost-effective, quality patient care.In this position, you will be responsible for monitoring utilization practices from preadmission to discharge, analyzing data to identify trends and areas for...

per diem, 8a-430p, ASN/ WE + Occ/ Hol About Us Milford Regional Medical Center is a full-service, community and regional teaching hospital located in Milford, Mass. and serves patients from more than 20 towns in Central Massachusetts. The 149-bed medical center is a nonprofit, acute-care facility, where more than 300 primary care and specialty physicians are...

Job Title: Utilization Review NurseAbout the Role:The Utilization Review Nurse plays a crucial role in ensuring the efficient use of healthcare resources while maintaining high standards of patient care.Main Responsibilities:Evaluates medical necessity to determine the most suitable treatment plan for patientsCollaborates with healthcare providers and payers...

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Job DescriptionJob Summary: Under the direction of the Utilization Review Manager and Physician Advisor, the Utilization Review Registered Nurse (UR-RN) assists in administration of utilization review functions. The UR RN will validate the documentation contained in the medical record. The UR RN will apply utilization review criteria, clinical...

Job DescriptionWe are seeking a skilled Registered Nurse to join our team as a Utilization Review Nurse. In this role, you will utilize your clinical expertise and communication skills to review patient information and determine the appropriateness of treatment plans.About the RoleAs a Utilization Review Nurse, you will be responsible for reviewing medical...