- Two years prior experience with Utilization Management.
- Previous training and demonstrated competence in negotiations, quality assurance, case management outcomes, and keyboarding/computer use.
- Experience with InterQual and/or Milliman Care Guidelines preferred. Strong organizational and time management skills.
- Ability to work on extremely complex problems where analysis of situations or data requires an evaluation of intangible variance factors
- Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners required.
- Bachelor's degree in Nursing
- Two years prior experience with Utilization Management.
- Previous training and demonstrated competence in negotiations, quality assurance, case management outcomes, and keyboarding/computer use.
- Experience with InterQual and/or Milliman Care Guidelines preferred. Strong organizational and time management skills.
- Ability to work on extremely complex problems where analysis of situations or data requires an evaluation of intangible variance factors
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Charge Nurse Recovery Full Time Days
1 week ago
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The Hospitals of Providence - Sierra Campus El Paso, TX, United States Full timeSummary The Assistant Director is a professional nurse who manages the daily operations of a department(s) with the Director of Nursing to provide services for patients while meeting quality, legal, organizational and medical staff goals. The Assistant Director is responsible for ...
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The Hospitals of Providence - Sierra Campus El Paso, TX, United StatesSummary · The Registered Nurse / RN provides direct clinical patient care. · The Registered Nurse / RN will assume responsibility for assessing, planning, implementing direct clinical care to assigned patients on a per shift basis, and unit level. · The Registered Nurse / RN i ...
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Assistant Nursing Director ER Full Time Days
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The Hospitals of Providence - East Campus EL PASO, United States Full time$15,000 Sign On Bonus available based for experienced RN Summary · The Registered Nurse / RN Telemetry provides direct clinical patient care. · The Registered Nurse / RN Telemetry will assume responsibility for assessing, planning, implementing direct clinical care to assigned p ...
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1 week ago
The Hospitals of Providence - Sierra Campus El Paso, TX, United States NursingSummary · The Medical/Surgical/Rehab Unit Registered Nurse is a professional nurse who coordinates the delivery of nursing care for pre/postoperative and medical patients through their hospital stay. The Registered Nurse participates in patient and family teaching, provides lead ...
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Registered Nurse Day Surgery Per Diem Rotate
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The Hospitals of Providence - Sierra Campus El Paso, TX, United StatesPOSITION SUMMARY · Under minimal supervision, provides nursing care for a group of patients assigned to the nurse based on matching the patients' needs with the nurse' competencies. Completes established competencies for the position within designated introductory period. Other r ...
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Tenet Healthcare El Paso, United States Full time$15,000 Sign On Bonus available based on experience Summary The Registered Nurse / RN Telemetry provides direct clinical patient care. · The Registered Nurse / RN Telemetry will assume responsibility for assessing, planning, implementing direct clinical care to assigned patients ...
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Registered Nurse Surgery Per Diem Days
9 hours ago
The Hospitals of Providence - Memorial Campus El Paso, United States Full timeUp to $30,000 Sign On Bonus available based on experience · Summary · The Perioperative Registered Nurse / RN is a professional nurse who coordinates the delivery of nursing care for the patient in the surgical suite. The Perioperative Registered Nurse / RN demonstrates competenc ...
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Registered Nurse ICU Per Diem Days
29 minutes ago
The Hospitals of Providence - East Campus El Paso, TX, United States· Summary · The Intensive Care / Coronary Care Registered Nurse is a professional nurse who coordinates the delivery of nursing care for critically ill, post operative, ventilator, post cardiac arrest, post heart cath, hemodynamic stabilization and other critically ill patients ...
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The Hospitals of Providence - Sierra Campus El Paso, TX, United States Part timeUp to $10,000 Sign-On bonus for experienced Registered Nurse / RN · Summary · This Registered Nurse / RN provides direct clinical patient care. · The Registered Nurse / RN will assume responsibility for assessing, planning, implementing direct clinical care to assigned patient ...
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The Hospitals of Providence - Trans Mountain Campus El Paso, TX, United States Full timeUp to $15,000 Sign On Bonus available based on experience · Summary · This Registered Nurse / RN Med Surg provides direct clinical patient care. · The Registered Nurse / RN will assume responsibility for assessing, planning, implementing direct clinical care to assigned patien ...
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Registered Nurse Telemetry Full Time Days Weekender
29 minutes ago
The Hospitals of Providence - East Campus El Paso, TX, United States Full timeUp to $20,000 Sign On Bonus available based on experience · POSITION SUMMARY · Under minimal supervision, provides nursing care for a group of patients assigned to the nurse based on matching the patients' needs with the nurse' competencies. Completes established competencies for ...
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Registered Nurse Day Surgery Per Diem Rotate
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The Hospitals of Providence El Paso, United StatesPOSITION SUMMARY · Under minimal supervision, provides nursing care for a group of patients assigned to the nurse based on matching the patients' needs with the nurse' competencies. Completes established competencies for the position within designated introductory period. Other r ...
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Registered Nurse Recovery Room Per Diem Days
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The Hospitals of Providence - East Campus El Paso, United StatesSummary · The Medical Oncology Unit Registered Nurse (RN) is a professional nurse who coordinates the delivery of nursing care for medical patients throughout their hospital stay. The RN demonstrates competency in the planning of care for patients across the care continuum. He/sh ...
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Assistant Nursing Director ER Full Time Days
3 weeks ago
Tenet Healthcare Corporation El Paso, United States Full timeSummary · The Assistant Director is a professional who coordinates program development, develops, assesses and pursues opportunities consistent with the business plan across Emergency Services for East Campus. Manages and directs multiple cost centers/departments across multiple ...
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The Hospitals of Providence El Paso, United States Full time$15,000 Sign On Bonus available based for experienced RN Summary The Registered Nurse / RN Telemetry provides direct clinical patient care. · The Registered Nurse / RN Telemetry will assume responsibility for assessing, planning, implementing direct clinical care to assigned pati ...
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29 minutes ago
The Hospitals of Providence - Sierra Campus El Paso, TX, United StatesSummary · The Registered Nurse / RN provides direct clinical patient care. · The Registered Nurse / RN will assume responsibility for assessing, planning, implementing direct clinical care to assigned patients on a per shift basis, and unit level. · The Registered Nurse / RN is ...
Utilization Review Nurse FT Days - El Paso, United States - El Paso Children's Hospital
Description
To monitor adherence to the hospital's utilization review plan to ensure the effective and efficient use of hospital services. Responsible for ensuring the appropriateness of hospital admissions and extended hospital stays. An understanding of the severity of an array of illnesses, intensity of service, and care coordination needs are the key, as the nurse must integrate clinical knowledge with billing knowledge to review, evaluate and arrange peer to peers when clinical denials related to medical necessity of the patient while hospitalized. UM nurse will work closely in collaboration with physician advisers to support policy development, and process improvement.
Required Skills
Required Experience
License/Registration/Certification:
Education and Training:
Qualifications:
