- The RN Utilization Review II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services.
- This RN is responsible for performing a variety of pre-admission, concurrent, and retrospective UM related reviews and functions.
- They must competently and accurately utilize approved screening criteria (InterQual/MCG/Centers for Medicare and Medicaid Services "CMS" Inpatient List).
- They effectively and efficiently manage a diverse workload in a fast-paces, rapidly changing regulatory environment and are responsible for maintaining current and accurate knowledge regarding commercial and government payors and Joint Commission regulations and guidelines related to UM.
- This RN effectively communicates with internal and external clinical professionals, efficiently organizes the financial insurance care of the patients, and relays clinical data to insurance providers and vendors to obtain approved certification for services.
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RN Utilization Review II
4 weeks ago
Impresiv Health Irving, United StatesTitle: RN Utilization Review II · Description: The RN Utilization Review II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This RN is responsible for performing a variety of ...
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Registered Nurse Utilization Review
3 weeks ago
CornerStone Irving, TX, United StatesCornerStone Medical is looking for a Registered Nurse Utilization Review for a state of the art hospital system in Irving, TX. This is an onsite role. Current RN Compact License required 8 am - 5 pm Monday - Friday $37/ Hr Summary: The RN Utilization Registered Nurse, Registered, ...
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Utilization Review RN
3 days ago
Texas Institute for Surgery Dallas, United StatesJob Details · Job Location · Texas Institute for Surgery LL SURG - Dallas, TX · Salary Range · $ $43.00 Hourly · Job Category · Health Care · Description · Job Summary: The Utilization Management Nurse will provide precertification of inpatient hospitalizations and all out ...
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rn utilization review ii
3 weeks ago
Impresiv Health Irving, TX , USA, United StatesTitle: RN Utilization Review II · Description: The RN Utilization Review II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This RN is responsible for performing a variety o ...
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Utilization Review RN
4 weeks ago
HireOps Staffing LLC Dallas, United StatesThis position is fully remote, however, you must reside in the State of Texas · The position is a contract for about 6 months. · RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the tre ...
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Utilization Review Specialist
2 weeks ago
Springstone, Inc Ft. Worth, United StatesMesa Springs is a 72-bed behavioral hospital located in Fort Worth, TX. The hospital offers inpatient and outpatient mental health and addiction treatment to adults, adolescents and their families. At Mesa Springs we are dedicated to Changing People's Lives. · Mesa Springs is lo ...
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Registered Nurse Utilization Review \ 1366
3 weeks ago
TalentBurst, Inc. Irving, TX, United StatesJob Title: Registered Nurse Utilization Review · Location: Irving, TX, 75038 · Duration: 13 Weeks · Shift: Monday - Friday 8 am - 5 pm · Pay Rate: $30/hr. - $35/hr. · Notes: Temp to Perm - Local Candidates only. Current RN Compact license required · Summary:The RN Utilization Rev ...
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Director of Utilization Review
3 weeks ago
ADDICTION AND MENTAL HEALTH SERVICES, LLC Waxahachie, United StatesJob Description · Job DescriptionTwo years minimum experience in utilization review. Must possess good grammatical and communication skills. Must be skilled in Microsoft Office applications and have a working knowledge of office equipment. · 1. Must be able to see and read handwr ...
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Registered Nurse Utilization Review \ 1366
3 weeks ago
Softpath System LLC Irving, TX, United StatesArea: HPUtilization Mgmt 7065 / 1346 · Class: RN Utilization Review · Shift: 1 · Start: 08:00:00 · End: 17:00:00 ...
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Utilization Review Specialist
4 weeks ago
Mesa Springs Fort Worth, United StatesOverview: · Mesa Springs is a 72-bed behavioral hospital located in Fort Worth, TX. The hospital offers inpatient and outpatient mental health and addiction treatment to adults, adolescents and their families. At Mesa Springs we are dedicated to Changing Peoples Lives. · Mesa S ...
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Parkland Health & Hospital System Dallas, United StatesInterested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and ...
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Utilization Review Coordinator
3 weeks ago
Carrus Hospital Frisco, United StatesCarrus Care Frisco mental health clinic serving the pediatric and adolescent population, is seeking a Utilization Review Coordinator (RN)ESSENTIAL FUNCTIONS:1. Responsible for coordinating andmonitoring day-to-day operations of the utilization management program for theoutpatient ...
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Utilization Review Specialist
3 weeks ago
Springstone Fort Worth, United StatesOverviewMesaSprings is a 72-bed behavioral hospital located in Fort Worth, TX.The hospital offers inpatient and outpatient mental health and addiction treatment to adults, adolescentsand their families. At MesaSprings we are dedicated to Changing Peoples Lives.Mesa Springs is loo ...
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Utilization Review Coordinator
3 weeks ago
Carrus Hospital Mansfield, United StatesCarrus Care Mansfield mental health clinic serving the pediatric and adolescent population, is seeking a Utilization Review Coordinator (RN)ESSENTIAL FUNCTIONS:1. Responsible for coordinating andmonitoring day-to-day operations of the utilization management program for theoutpati ...
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Utilization Review Intake Specialist
3 weeks ago
Virgin Pulse Plano, United StatesOverview · Now is the time to join us · Virgin Pulse and HealthComp are now Personify Health. The industry's first personalized health platform company combines health, wellbeing, and navigation solutions to deliver powerful outcomes to businesses and their people. At Personify H ...
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OCOK Utilization Review Specialist
4 weeks ago
Shelby American Inc Fort Worth, United StatesPosition Function : Responsible for ensuring that youth receive the most appropriate level of residential services for well-being and to achieve permanency. Responsible for ensuring that exceptional services and/or placement waivers are secured and reviewed, with all deadlines me ...
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OCOK Utilization Review Specialist
4 weeks ago
Shelby American Inc Fort Worth, United StatesPosition Function · : · Responsible for ensuring that youth receive the most appropriate level of residential services for well-being and to achieve permanency. Responsible for ensuring that exceptional services and/or placement waivers are secured and reviewed, with all deadli ...
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OCOK Utilization Review Specialist
3 weeks ago
ACH Child and Family Services Fort Worth, United StatesPosition Function : Responsible for ensuring that youth receive the most appropriate level of residential services for well-being and to achieve permanency. Responsible for ensuring that exceptional services and/or placement waivers are secured and reviewed, with all deadlines me ...
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Parkland Health and Hospital System Dallas, United StatesInterested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and ...
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Nurse (Utilization Review Nurse)
1 week ago
Justice, Bureau Of Prisons/Federal Prison System Fort Worth, United States Full timeThis position is located in the Health Services Department of a Bureau of Prisons (BOP), Medical Referral Center (MRC), Medical Care Level 3 facility, or Federal Correctional Complex (FCC). Serves as the Utilization Review Nurse and assists in quality improvement activities throu ...
RN Utilization Review - Irving, United States - Tekaccel
Description
Summary: