- Careerbuilder-US (Atlanta, GA)
- Job Title: Utilization Review Nurse I Location: 100% Remote Duration: 3 months (Possibility of extension) Shift timings: 8:00 AM to 5:00 PM EST (Mon-Fri) Pay ... of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review . . Assesses services for Client Members to… more
- TalentBurst, Inc (Irving, TX)
- …providers and vendors to obtain approved certification for services. The RN Utilization Review Nurse collaborates as necessary with other members of the health ... TalentBurst, Inc is seeking a travel nurse RN Utilization Review for a...RN is responsible for performing a variety of pre-admission, concurrent , and retrospective UM related reviews and functions. They… more
- UT Health Tyler (Tyler, TX)
- …care team. Plans and coordinates a comprehensive plan of care using a concurrent integrated review , standard operating procedures, case management tools, and ... to $20,000 Join our team as a full-time, day shift, Case Manager Registered Nurse in Tyler, TX. Fulfilling your purpose begins here: People First, Always. Here's how… more
- InnovaCare (San Juan, PR)
- …customer focus to the business. MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the ... Inpatient within forty-eight (48) hours of having performed the first concurrent review of notified admission cases.4. On a daily basis, concurrently reviews… more
- Centene Corporation (New York, NY)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs daily medical necessity reviews. This position reports to the ... at any time with or without notice. Primary Responsibilities + Performs concurrent utilization reviews (Acute, SNF, LTACH, ARF) and first level determination… more
- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a CDI Concurrent Review Lead WFH you want with your current employer? We have an ... colleagues. Do you want to work as a CDI Concurrent Review Lead WFH where your passion...1+ year of experience in inpatient CDI + Registered Nurse - Currently licensed as a registered professional … more
- RWJBarnabas Health (Jersey City, NJ)
- Nurse Midwife(FT) Days- MMG Concurrent -Jersey CityReq #:0000106025 Category: Nurse Midwife Status:Full-Time Shift:Day Facility:Jersey City Medical Center ... Department:MMG Concurrent Location: Jersey City Medical Center, 355 Grand Street,...Street, Jersey CIty, NJ 07302 Job Overview- The Certified Nurse Midwife position provides antepartum, intrapartum, postpartum, neonatal and… more
- HCA Healthcare (Nashville, TN)
- …work environment where diversity and inclusion thrive? Submit your application for our CDI Concurrent Review and Query Specialist WFH opening with HCA today and ... may vary by location._** We are seeking a(an) CDI Concurrent Review and Query Specialist WFH for...care facility required Licenses, Certifications, & Training: + Registered Nurse - Currently licensed as a Registered Professional … more
- Trinity Health (Fresno, CA)
- …maintaining current knowledge of clinical indicators and compliance requirements, conducting concurrent medical record review to ensure documentation compliance ... Health Science, or related field is preferred. 2. Current licensure as a Registered Nurse in the State of California is required. 3. Thorough knowledge of healthcare… more
- Sharp HealthCare (San Diego, CA)
- …Medical-Surgical Nursing, and/or Home Health. + 1 Year Utilization Management/ Concurrent review experience. + California Registered Nurse (RN) - CA Board of ... **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree in Nursing… more
- Martin's Point Health Care (Portland, ME)
- …as a "Great Place to Work" since 2015. Position Summary Job Description The Utilization Review Nurse works as a member of a team responsible for ensuring the ... receives and reviews notification of emergent hospital admissions, completes inpatient concurrent review , establishes discharge plans, coordinates transitions of… more
- Medical Mutual of Ohio (OH)
- …provider manual.** + **Performs other duties as assigned.** **Qualifications** **Quality Safety Review Nurse ** **Education and Experience** + **Graduate of a ... organize work by priority. + Demonstrated project management skills. **Sr Quality Safety Review Nurse ** **Education and Experience** + Graduate of a registered… more
- Beth Israel Lahey Health (Burlington, MA)
- …being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for ... is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three payments. You… more
- Beth Israel Lahey Health (Needham, MA)
- …being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for ... people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status based on… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of the Utilization Review Team and ... clinical review prior to payment. The Utilization Review Nurse will use appropriate governmental policies...also review prior authorization requests (prior authorization, concurrent review , and retrospective review )… more
- Actalent (Kansas City, KS)
- …+ Discharge planning + Transition of care management + Length of stay management + Concurrent Review Job Type This is a Contract-to-Hire position with a duration ... Job Title: Utilization Review - Post Acute Care Job Description Our PAC Nurse is a telephonic role responsible for recommending discharge plans, assisting with… more
- Health First (Melbourne, FL)
- …**Job:** **Case Management* **Organization:** **Holmes Regional Medical Center* **Title:** *Utilization Review Nurse - Case Management UR Part Time* ... *POSITION SUMMARY* The Utilization Review (UR) nurse performs medical necessity...Electronic Medical Record and other applications that initial and concurrent reviews have been appropriately completed. 5. Promotes professional… more
- Texas Health Resources (Fort Worth, TX)
- …tools, Lean Principles, and statistical analysis. What you will do . Concurrent review of medical records against pre-established criteria/quality initiatives. . ... **RN - Medical Staff Peer Review ** _Are you looking for a rewarding career...experience Preferred. **Licenses and Certifications** . RN - Registered Nurse Upon Hire Req And . CPHQ - Certified… more
- Ascension Health (Manhattan, KS)
- …health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within assigned ... unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement...team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
