- CDPHP (Latham, NY)
- …and appropriate exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care ... DME requests and inpatient readmissions. In collaboration with management, the UR nurse identifies potentially high-cost admissions and extended stays.… more
- UNC Health Care (Kinston, NC)
- …admission, and continued stay reviews and related activities as needed to support UR Nurse team. **Other Information** Other information: + **EDUCATION** + ... documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying established criteria to evaluate the… more
- Beth Israel Lahey Health (Exeter, NH)
- …outcomes. 3. Serves as a liaison among the patient, family members, physicians, nurse , social worker, UR nurse , insurance representative and community ... Registered Nurse Case Manager + Full Time + Exeter,...Seacoast, with easy access to Boston and Portland The Nurse Case Manager/Discharge Planner collaborates, facilitates and negotiates the… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review ( UR ) Registered Nurse is responsible for evaluating the ... *_SUMMARY:_* We are currently seeking a*Staff Nurse *to join our Utilization Management department for the/Emergency Department / This position is a*0.6 FTE (6… more
- Community Health Systems (Naples, FL)
- …partners with providers and staff to drive compliance with utilization policies. The UR Nurse also contributes to the development of departmental procedures, ... Join us as a **Registered Nurse (RN) - Utilization Review position** at Physicians...internal departments to promote process improvement and compliance with UR standards and KPIs. + Serves as a resource… more
- Providence (Olympia, WA)
- **Description** The Utilization Review ( UR ) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management ... we must empower them. **Required Qualifications:** + Upon hire: Washington Registered Nurse License + 3 years of Nursing **Preferred Qualification:** + Bachelor's… more
- San Antonio Behavioral Health (San Antonio, TX)
- …staff as needed. Essential Duties: + Collaborate and set standards with registered nurse (RN) case managers (CMs) and outcome managers to ensure that all ... of appeal letters. + Tracks denial information for reporting to Quarterly UR Committee. + Maintains liaison with the Social Services department to facilitate… more
- Trinity Health (Fresno, CA)
- …effective utilization of the facility's resources. 1. Current licensure as a Registered Nurse (RN) in the state of California is required. 2. Current American Heart ... Association (AHA) Healthcare Provider CPR card is preferred. 3. Degree from an accredited baccalaureate nursing program (BSN) is preferred. 4. Certified Case Manager (CCM) national certification is preferred. 5. Interquel training must be obtained within six… more
- Emory Healthcare/Emory University (Decatur, GA)
- …leadership programs + And more **Description** We're seeking a **Clinical Utilization Review Nurse Preceptor (Registered Nurse / RN)** . This individual will be ... cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor: + Will be regarded as a clinical expert, leader, and… more
- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review ( UR ) and utilization management (UM) program for all TRICARE eligible beneficiaries within the CMHS. ... link between the providers, staff, and civilian sectors regarding UR guidelines. + Determine if the services requested are...active, and unrestricted license to practice as a registered nurse . + Must be a graduate from a college… more
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