UNKNOWN

FEED

Utilizing advanced clinical knowledge, the CDS role requires the ability to review the medical record accurately and timely, recognize opportunities for documentation improvements, formulate clinically credible documentation clarifications, follow-up timely on all cases, especially those requiring clinical documentation clarifications, and communicate effectively and appropriately with the physicians. Demonstrates advanced clinical expertise including understanding of nursing anatomy/pathophysiology, disease processes, pharmacology, advanced critical thinking, deductive reasoning and problem solving skills.

HOUR

Enloe Medical Center

Clinical Documentation Specialist - Utilization Management (Full-Time, Days)

Requires lifting and carrying equipment and supplies weighing up to 35 pounds; requires pushing and pulling equipment and supplies weighing up to 35 pounds; requires walking and standing; requires frequent sitting more than 75% of the workday; requires the ability to negotiate stairs; requires visual acuity and manual dexterity to operate equipment. Through innovative home- and community-based services, Vitra supports aging adults, people with disabilities, and individuals with complex care needs— supported by a Nurse, and Case Manager, Vitra ensures clients receive compassionate, personalized, and dignified care.

VITRA Health

Quality Review Registered Nurse

ea_via_bold

The QUS through regular reviews and audits and collaboration with the clinical team, facilitates responsible decisions that promote cost effective health care services as evidenced by appropriate level of care assignment and medical necessity documentation consistent with the patient's clinical state and intervention plan. As such, the QUS participates in performance improvement initiatives, implements work process changes, monitors performance, and facilitates necessary changes, under the purview of the Department leadership and in collaboration with practicing clinicians, based on data trends.

Northwestern Memorial HealthCare

Quality Utilization Specialist Full-time, Days, Hybrid ($4,000 sign-on bonus)

Responsibilities: In collaboration with the oncologist provides direct patient care, initial and ongoing assessment, patient education, management of chemotherapy effects, medicine reconciliation, and coordination of care of patients enrolled in protocols and clinical trials. Coordinates the operations of assigned clinical area including protocol and non-protocol chemotherapy regimens, calculating dosages and administering intravenous chemotherapy, patient scheduling, patient records, and patient admission for adult cancer patients.

University of Mississippi Medical Center

RN - Oncology - Ambulatory

Lead Discharge Planning and Care Transitions - Develop and coordinate individualized discharge plans, arrange post-acute services, and ensure timely, safe transitions to prevent delays and reduce readmissions. In collaboration with the interdisciplinary team, the case manager supports the physician in facilitating patient care with the objective of enhancing the quality of patient outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers.

Presbyterian System Services

RN Inpatient Case Manager

ADAPTED_NOW

The Care Manager collaborates with social work, physicians, nurses and multidisciplinary team, lending professional care management expertise to ensure quality, timely and cost effective case management for an identified patient population and addresses issues or patterns in patient readmission. Under the direction of the Care Management Team Lead, the Director of Care Management, and through coordination with nursing, social work, physicians and other members of the interdisciplinary team, the Care Manager develops, facilitates and implements appropriate case management and discharge plans.

Phoebe Putney Health System

RN Care Manager - Phoebe Sumter Hospice

nas_phoebehealthorganic

1+ year of Case management or utilization review experience in a hospital or related setting (Preferred) CERTIFICATIONS Registered Nurse (RN) with current Georgia license (Required) Certified Case Manager upon hire (Preferred) ESSENTIAL FUNCTIONS JOB KNOWLEDGE - CARE MANAGER: Understands and fulfills job responsibilities and expectations and applies knowledge and skills to function proficiently in CM role. The Care Manager collaborates with social work, physicians, nurses and multidisciplinary team, lending professional care management expertise to ensure quality, timely and cost effective case management for an identified patient population and addresses issues or patterns in patient readmission.

RN Care Manager -PSMC

The Staff Pad is proud to partner with a respected healthcare organization in Hamilton, TX to recruit an experienced Case Management Manager who is passionate about improving patient outcomes, leading high-performing teams, and ensuring safe, efficient transitions of care. If you're a collaborative nurse leader who thrives in a fast-paced acute care environment looking to lead a dedicated Case Management team while making a lasting impact on patients and their families, we encourage you to apply today!

The Staff Pad

RN Case Management Manager | Lead Patient Care & Care Transitions

Zoho

Will monitor post discharge, prebill accounts that do not have an authorization on file, ALOS versus days authorized variances, and/or other account discrepancies identified that will result in the account being denied by the payor that require clinical expertise. Utilizing mcg Indicia, clinical reviews are performed and clinical information shared with payers and authorization status shared with the care team on the coordination of safe transitions of care for a defined patient population.

<p>As the largest healthcare system in the suburbs of Atlanta, WellStar serves more than a million patients a year within our hospitals, health parks, urgent care centers, and medical practices in NW Atlanta. We are a leading not-for-profit health system with state-of-the-art medical technology and a world-class employee family. Onsite concierge services, pension plans and job sharing are just the start of our innovative vision of a ‘Work Life Well Lived!’</p>

WellStar Health System Inc

Registered Nurse (RN) -Acute Care - Uitilization Managment PRN Days

We are pleased to announce the following available position: Utilization Outcomes Specialist - Denials, Appeals & Grievances The main duties of the Utilization Outcomes Specialist are: to coordinate and monitor appropriate utilization and documentation of services throughout the course of treatment for patients admitted to the inpatient and outpatient programs and coordinate authorization with third-party payors. Other duties include; recommending plans of corrective action and monitoring the impact of the action taken; maintaining communication system based on documentation and verbal exchange regarding treatment; and communicating with internal and external entities to facilitate acquisition of resources.

University Health Services Inc

UTILIZATION OUTCOMES SPECIALIST

FULL_TIME

OCCASSIONAL (up to 33%): stooping, kneeling squatting, body twisting, sense of touch, climbing on/off truck, gripping, lifting over 10 lbs. to 50 lbs., reaching, lifting, carrying, pushing, pulling, climbing ladders, balancing, lifting over 50 lbs. The groundperson is responsible for gathering and feeding brush & debris into a woodchipper, scanning areas from trip and fall hazards, ensuring other workers stay out of the path of travel.

Asplundh Tree Expert

Groundperson - NON-UNION

Jobvite Talemetry Organic Easy Apply

Current Basic Life Support certification (AHA or Red Cross)· Three years of registered nursing experience, including at least one year in referralmanagement, utilization management, case management, quality management, orambulatory care. Years of Professional Experience: Three years of registered nursing experience including at least one year in referral management, utilization management, case management, quality management, or ambulatory care Powered by JazzHR.

Resolution Think

Registered Nurse (RN)

American Traveler is hiring an RN Case Manager for an inpatient acute care case management role requiring 2 years of RN experience and 1 year as a Case Manager with an OK or compact RN license. With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements.

WEEK

American Traveler

Travel RN Case Manager - $2,367 per week

One Red Cent - Marketplace

American Traveler is hiring an RN Case Manager for an acute care hospital setting, requiring 2 years of acute hospital case management experience and a CA RN license. Must commit to working 3 of 5 major holidays (Thanksgiving, Christmas Eve, Christmas Day, New Year's Eve, New Year's Day).

Travel Case Management RN - $3,112 per week

As the largest healthcare system and largest private employer in Oregon, Providence is located in areas ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.

<h1><img src="http://seo.nlx.org/providence/img/locations/washington.jpg" /></h1>
<h1>Our Mission is more than just words.</h1>
<h4>About Us</h4>
<p>As the third largest not-for-profit health system in the United States, we are committed to providing for the needs of our communities &ndash; especially for those who are poor and vulnerable &ndash; across Alaska, California, Montana, Oregon and Washington.</p>
<p>Our system includes more than 82,000 caregivers (all employees) serving in a diverse range of ministries from birth to end of life, including acute care, physician clinics, long-term and assisted living, palliative and hospice care, home health, supportive housing and education.</p>
<h4>Where we serve</h4>
<p>We operate 34 hospitals, 600 physician clinics, 22 long-term care facilities, 19 hospice and home health programs and 693 supportive housing units in 14 locations. Our health plan serves our caregivers and other large employer groups covering 513,000 members.</p>
<p>On any given day, we care for more than 1,200 people in our long-term care settings, more than 4,000 in our hospitals and more than 15,000 in our clinic settings. Daily, we serve more than 7,000 people in our many home health and palliative care programs and almost 800 in supportive housing. We touch more than five times as many lives in non-acute settings as we do in the traditional hospital setting.</p>
<h4>A tradition of caring for everyone</h4>
<p>When the Sisters arrived in the Pacific Northwest in 1856, they came to answer a call for help from a new pioneer community. What they found were many communities in need of service, and so with dedication to the Mission and collaboration with like-minded partners, their ministry grew to what is now a five-state health system.</p>
<p>Providence Health &amp; Services continues a tradition of caring that the Sisters of Providence began more than 158 years ago. The cornerstone of our Mission is to provide compassionate care that is accessible for all &ndash; especially those who are poor and vulnerable.</p>
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<h1><img src="http://seo-nlx-org.s3.amazonaws.com/providence/img/benefits_fatherdaughter.jpg" /><img src="http://seo-nlx-org.s3.amazonaws.com/providence/img/benefits_family.jpg" /></h1>
<h1>We believe making a difference is one of our greatest rewards.</h1>
<h4>Caring is what we do.</h4>
<p>Our benefits help us care for our employees and their families by supporting their wellness and providing tools that promote financial security and&nbsp;professional growth.*</p>
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<h4>Benefits:</h4>
<ul class="bullet-list">
<li>Medical, dental and vision insurance coverage that start on your first day</li>
<li>Retirement program that helps you prepare for your future</li>
<li>Life and AD&amp;D insurance</li>
<li>Health Reimbursement and Savings Accounts (HRA, HSA, FSA)</li>
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<h4>Well-being:</h4>
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<li>Health assessment and personal coaching to help you meet your goals</li>
<li>Incentives for participation in healthy activities</li>
<li>Caregiver Assistance Program (for employees) offering work/life services, resources and expertise when you need it</li>
<li>Weight management, tobacco cessation and diabetes programs</li>
</ul>
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<h4>Work/Life Balance:</h4>
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<li>Volunteers in Partnership program to match you with volunteer opportunities that support our communities</li>
<li>Support for life events such as birth, adoption, marriage or other changes to your family</li>
<li>Ergonomics and injury prevention to promote safe work environments</li>
<li>Paid time off</li>
<li>Disability benefits</li>
</ul>
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<h4>Career and Development:</h4>
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<li>Tuition reimbursement to support your education as you tackle your career goals</li>
</ul>
<p><img src="http://seo-nlx-org.s3.amazonaws.com/providence/img/01sunlightshining.jpg" /></p>
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</div>
<h1>Awards and Recognition</h1>
<h4>Healthcare Excellence</h4>
<p>We are deeply honored that Providence facilities have been distinguished with national awards and certifications. At Providence Health &amp; Services, our dedication to excellence is evident in the service our people demonstrate every day. Here, you&rsquo;ll find an environment built on the core values of respect, compassion, justice, excellence and stewardship. They are at the heart of everything we do...and others have noticed.</p>
<p><img src="http://seo.nlx.org/jobs.providenceiscalling.jobs/img/static-page/awards/jd.png" alt="JD Power and Associates Distinguished Hospital Award for Service Excellence" />&nbsp;&nbsp;<img src="http://seo.nlx.org/jobs.providenceiscalling.jobs/img/static-page/awards/oregon-business.png" alt="'100 Best Companies to Work For' -Oregon Business magazine" />&nbsp;&nbsp;<img src="http://seo.nlx.org/jobs.providenceiscalling.jobs/img/static-page/awards/alaska-medical.png" alt="Cardiac Surgery Excellence Award" /></p>
<p><img src="http://seo.nlx.org/jobs.providenceiscalling.jobs/img/static-page/awards/working-mother.png" alt="'100 Best Companies for Working Mothers' Award" />&nbsp;&nbsp;<img src="http://seo.nlx.org/jobs.providenceiscalling.jobs/img/static-page/awards/magnet.png" alt="Magnet Hospital for Excellence in Nursing Services - American Nurses Credentialing Center (ANCC)" />&nbsp;&nbsp;<img src="http://seo.nlx.org/jobs.providenceiscalling.jobs/img/static-page/awards/five-star.png" alt="Five-Star Hospital Award" /></p>
<p><img src="http://seo.nlx.org/jobs.providenceiscalling.jobs/img/static-page/awards/solucient.png" alt="'100 Top Hospitals' - Solucient" />&nbsp;&nbsp;<img src="http://seo.nlx.org/jobs.providenceiscalling.jobs/img/static-page/awards/qualis.png" alt="Award of Excellence in Healthcare Quality - Qualis Health" />&nbsp;&nbsp;<img src="http://seo.nlx.org/jobs.providenceiscalling.jobs/img/static-page/awards/thomson.png" alt="Thomson Reuters '100 Top Hospitals' Award" /></p>
<p><img src="http://seo.nlx.org/jobs.providenceiscalling.jobs/img/static-page/awards/ceo.png" alt="'Washington's 100 Best Companies' - CEO magazine" />&nbsp;&nbsp;<img src="http://seo-nlx-org.s3.amazonaws.com/jobs.providenceiscalling.jobs/img/static-page/awards/HealthgradesDistingHospital2017.jpg" alt="'Distinguished Hospital Clinical Excellence 2017" /></p>

Providence Health & Service

Utilization Review RN

IRecruitee

The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually.

YEAR

Prime Healthcare Management

Utilization Review Nurse LVN

For medication reviews, evaluate prior authorization requests using applicable benefit, formulary, step-therapy, quantity-limit, and clinical criteria; obtain medication history and supporting documentation; and refer exceptions or complex requests for Medical Director review as appropriate. For inpatient reviews, evaluate admission information and continued-stay documentation, monitor authorized days and level of care, request additional clinical information when needed, and escalate cases involving extended stays, discharge barriers, or other clinical concerns.

Alliance Coal LLC

Utilization Review Nurse

The role integrates discharge planning, care coordination, utilization review, resource management, regulatory compliance, and patient advocacy to ensure safe transitions of care, optimal outcomes, and appropriate utilization of healthcare resources. Employee voluntary benefits such as Discounted RFTA bus passes, discounted gym memberships, Corporate Ski passes, free car seat for new Valley View babies born or adopted by Valley View employee(s).

Valley View

Case Manager (RN) Full-Time

The Director is responsible for directing and coordinating regulatory and accreditation functions, ensuring appropriate preparation, and active participation of appropriate staff and managers for agencies such as The Joint Commission (TJC), Florida’s Agency for Healthcare Administration (AHCA), and/or the Centers for Medicare and Medicaid Services (CMS) and to formulate responses to accreditation findings and inquiries. The Director will ensure an ongoing mechanism for proactive monitoring and auditing is developed, continually updated, and executed on a regular schedule and the results of any monitoring or auditing are made available to the appropriate leadership.

<h4>Overview</h4>
<p>K.A. Recruiting is a Healthcare Recruiting company that was established in order to serve the growing need for allied healthcare professionals, doctors, nurses, nurse practitioners, pharmacists, physician assistants and physical therapists. We help to find top notch candidates for hospitals, reference labs, long-term care facilities, home health agencies, rehabilitation centers, non profit organizations, etc. CHECK OUT OUR CURRENT JOB OPPORTUNITIES: JOBS.KA-RECRUITING.COM Like us on Facebook: https://www.facebook.com/pages/KA-Recruiting-Inc/210685185178</p>
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<dt>Website</dt>
<dd><a href="http://www.ka-recruiting.com/" target="_blank" rel="noopener noreferrer"><span dir="ltr">http://www.ka-recruiting.com</span></a></dd>
<dt>Industry</dt>
<dd>Staffing and Recruiting</dd>
</dl>

K.A. Recruiting

Director of Quality RN

HaleyMarketing

OTHER

Degree in nursing or equivalent combination of education/related experience: Required Master's Degree: Preferred Five years' technical experience: Preferred Supervisory experience or demonstrated supervisory skills: Required Licenses/Certifications: Registered Nurse (RN) licensure in the state of practice: Required Cardiopulmonary Resuscitation (CPR) certification or Basic Life Support (BLS OR HS-BLS OR RQIBLS) certification from approved vendor per AH policy: Preferred Clinical specialty and/or nursing administration certification: Preferred Department Specific License/Certifications: AHA-BLS or ARC-BLS: Required Essential Functions: Provides unit-based leadership in the development and provision of clinical services. Located halfway between San Francisco and Los Angeles, San Luis Obispo is situated in the heart of California's Central Coast where you can spend your day exploring miles of white, sandy beaches, browsing through quaint stores and museums, wine tasting or hiking or bicycling in and around the rolling hills.

Utilization Review Nurse Jobs in the United States

Clinical Documentation Specialist - Utilization Management (Full-Time, Days) Enloe Medical Center

Quality Review Registered Nurse VITRA Health

Quality Utilization Specialist Full-time, Days, Hybrid ($4,000 sign-on bonus) Northwestern Memorial HealthCare

RN - Oncology - Ambulatory University of Mississippi Medical Center

RN Inpatient Case Manager Presbyterian System Services

RN Care Manager - Phoebe Sumter Hospice Phoebe Putney Health System

RN Care Manager -PSMC Phoebe Putney Health System

RN Case Management Manager | Lead Patient Care & Care Transitions The Staff Pad

Registered Nurse (RN) -Acute Care - Uitilization Managment PRN Days WellStar Health System Inc

UTILIZATION OUTCOMES SPECIALIST University Health Services Inc

Groundperson - NON-UNION Asplundh Tree Expert

Registered Nurse (RN) Resolution Think

Travel RN Case Manager - $2,367 per week American Traveler

Travel Case Management RN - $3,112 per week American Traveler

Utilization Review RN Providence Health & Service

Utilization Review Nurse LVN Prime Healthcare Management

Utilization Review Nurse Alliance Coal LLC

Case Manager (RN) Full-Time Valley View

Director of Quality RN K.A. Recruiting

Travel Nurse RN - Operating Room - $2,896 to $3,044 per week in San Luis Obispo, CA TravelNurseSource

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