Clinical Utilization Management Nurse - Madison

Only for registered members Madison, United States

1 month ago

Default job background

Job summary

The Clinical Utilization Management Nurse (PRN) is responsible for performing utilization review activities on an as-needed basis to ensure appropriate use of medical resources, compliance with regulatory requirements,
and adherence to clinical best practices.

Responsibilities

  • Perform admission, concurrent, and discharge reviews to determine medical necessity and appropriate level of care
  • Apply InterQual/MCG criteria and payer guidelines to support clinical decisions
  • Ccommunicate with physicians and care teams to address documentation gaps and ensure compliance with CMS and commercial payer requirements

      Lorem ipsum dolor sit amet
      , consectetur adipiscing elit. Nullam tempor vestibulum ex, eget consequat quam pellentesque vel. Etiam congue sed elit nec elementum. Morbi diam metus, rutrum id eleifend ac, porta in lectus. Sed scelerisque a augue et ornare.

      Donec lacinia nisi nec odio ultricies imperdiet.
      Morbi a dolor dignissim, tristique enim et, semper lacus. Morbi laoreet sollicitudin justo eget eleifend. Donec felis augue, accumsan in dapibus a, mattis sed ligula.

      Vestibulum at aliquet erat. Curabitur rhoncus urna vitae quam suscipit
      , at pulvinar turpis lacinia. Mauris magna sem, dignissim finibus fermentum ac, placerat at ex. Pellentesque aliquet, lorem pulvinar mollis ornare, orci turpis fermentum urna, non ullamcorper ligula enim a ante. Duis dolor est, consectetur ut sapien lacinia, tempor condimentum purus.
      Get full access

      Access all high-level positions and get the job of your dreams.



Similar jobs

  • Work in company

    Nurse Manager

    Only for registered members

    The NICU Nurse Manager sets direction and partners with the multidisciplinary NICU Leadership Team for the largest birthing hospital in the state of WI. · At UnityPoint Health, you matter. We're proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcar ...

    Meriter Hospital

    3 days ago

  • Work in company

    Nurse Manager

    Only for registered members

    The NICU Nurse Manager sets direction and partners with the multidisciplinary NICU Leadership Team for the largest birthing hospital in the state of WI. · ...

    Madison, WI

    2 weeks ago

  • Work in company

    Nurse Manager

    Only for registered members

    The NICU Nurse Manager sets direction and partners with the multidisciplinary NICU Leadership Team for the largest birthing hospital in the state of WI. · The Nurse Manager is responsible for promoting a collaborative environment in which excellence in patient care can be delive ...

    Madison

    2 weeks ago

  • Work in company

    Nurse Manager

    Only for registered members

    We are seeking a Registered Nurse (RN) for a Nurse Manager to direct patient care programs, · lead clinical operations, · evaluate departments workforce, · and prepare revenue budgets.Benefits include: · An excellent benefits package,A variety of schedules · Paid time off · Tuiti ...

    Madison

    1 week ago

  • Work in company

    Nurse Manager

    Only for registered members

    We are seeking a Registered Nurse (RN) for a Nurse Manager position in University Hospital in Madison,WI. · An excellent benefits package including health and dental insurance,paid time off retirement plans,two-week paid parental leave and adoption assistance · ...

    Madison Full time

    1 week ago

  • Work in company

    Nurse Manager ICU

    Intermountain Health

    This role involves managing and supervising nursing departments. · Collaborating with nursing leaders and other facility managers and departments, the nurse manager is key in ensuring excellent patient care, achieving financial objectives, and fostering leadership development. ...

    Madison

    16 hours ago

  • Work in company

    Interim Nurse Manager

    Only for registered members

    Bedrock Health Care Center is looking for a Nurse Manager (RN) to join their team. · ...

    Madison, WI

    1 day ago

  • Work in company

    RN - Nurse Manager

    Only for registered members

    Experienced RN - Nurse Manager for our customer in Madison, Wisconsin. · Nurse Manager US nursing experience as a RN - Nurse Manager · ...

    South Park Street, Madison, WI, US

    1 week ago

  • Work in company

    Clinical Nurse Manager

    Only for registered members

    The Division of Behavioral Health and Recovery is pleased to announce an opening for a Clinical Nurse Manager (CNM) for the Forensic Units AFC at Alton Mental Health Center located in Madison. · ...

    Madison, Wisconsin, United States

    3 days ago

  • Work in company

    Nurse Case Manager

    Only for registered members

    We are seeking a Nurse (RN) Case Manager: · Bring a strong clinical background, case management experience and well-developed assessment and critical thinking skills · Assist with anticipating the discharge needs of post-surgical patients to ensure timely discharge and access to ...

    Madison, WI, United States

    6 days ago

  • Work in company

    Nurse Case Manager

    Only for registered members

    We are seeking a Nurse (RN) Case Manager: Bring a strong clinical background, case management experience and well-developed assessment and critical thinking skills. Assist with anticipating the discharge needs of post-surgical patients to ensure timely discharge and access to the ...

    Madison, WI, United States

    6 days ago

  • Work in company

    Nurse Case Manager

    Only for registered members

    Nurse Case Manager. Join the #1 hospital in Wisconsin. · Be part of something remarkable. · ...

    Madison, WI, United States

    1 day ago

  • Work in company

    Program Manager, Nursing

    Only for registered members

    The Universities of Wisconsin Office of Online Professional & Learning Resources is hiring a Program Manager for Nursing & Health Professions We offer extensive benefits including 200+ hours of leave time additional sick time participation in the Wisconsin Retirement System WRS c ...

    Madison, WI

    1 month ago

  • Work in company

    Nurse Case Manager

    Only for registered members

    We are seeking a Nurse (RN) Case Manager · Bring a strong clinical background, case management experience · ...

    Madison

    1 month ago

  • Work in company

    Nurse Case Manager

    Only for registered members

    We are seeking a Nurse (RN) Case Manager: Bring a strong clinical background, case management experience and well-developed assessment and critical thinking skills · Assist with anticipating the discharge needs of post-surgical patients to ensure timely discharge and access to t ...

    Madison

    1 month ago

  • Work in company

    Interim Nurse Manager

    Only for registered members

    Are you looking for a warm and cozy environment to call your next work home? Do you want stability and longevity in your career? We would love for you to join our tight-knit family of caregivers that serves our residents everyday with compassion, care and a positive attitude. · U ...

    Madison

    1 day ago

  • Work in company

    Nurse Case Manager

    Only for registered members

    We are seeking a Nurse (RN) Case Manager to bring strong clinical background and case management experience. · Assist with anticipating the discharge needs of post-surgical patients to ensure timely discharge and access to the best possible resources. · Have an understanding of m ...

    Madison

    1 month ago

  • Work in company

    Nurse Case Manager

    Only for registered members

    +We are seeking a Emergency Department Nurse (RN) Case Manager at University Hospital in Madison. · Bring a strong clinical background, case management experience and well-developed assessment and critical thinking skills · ...

    Madison

    1 month ago

  • Work in company

    Program Manager, Nursing

    Only for registered members

    The Universities of Wisconsin Office of Online Professional & Learning Resources is hiring a Program Manager for Nursing & Health Professions. · We offer extensive benefits and so much more Please click the link below to learn more and apply Career Opportunities · Nursing & Healt ...

    Madison

    1 month ago

  • Work in company

    Veterinary Nursing Manager

    Only for registered members

    At VEG we find a way to say yes to the career you want in veterinary emergency medicine. This means transforming how ER works, from our open-concept hospitals, where you can handle emergency cases of every kind (even exotics) to our immersive, customer-focused experience, · Manag ...

    Madison

    1 week ago

  • Work in company

    Nurse Case Manager

    Only for registered members

    Weare seeking a Nurse (RN) Case Manager. · Bring a strong clinical background, case management experience and well-developed assessment and critical thinking skills. · Assist with anticipating the discharge needs of post-surgical patients to ensure timely discharge and access to ...

    Madison Full time

    1 month ago