Utilization Review Nurse - Miami, FL

Urgent Hiring for Remote Clinical Review Nurses. · ...

Urgent Hiring for Remote Clinical Review Nurses to review approximately 20 cases a day for medical necessity and advocate for and protect members from unnecessary hospital admissions. · ...

The Utilization Nurse is responsible for conducting prospective concurrent and retrospective clinical reviews to determine medical necessity level of care and appropriateness of services across the continuum · This role collaborates closely with hospital UR/Case Management facili ...

The Nurse Reviewer I role enables associates to work virtually full-time except for required in-person training sessions providing maximum flexibility and autonomy.This approach promotes productivity supports work-life integration ensures essential face-to-face onboarding skill d ...

We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence. · Responsible to initiate and monitor service utilization including hospital, · sub-acute, · and post acute care utilized by participants. · ...

Under the general supervision of the Inpatient Services Manager, the Concurrent Review Nurse is responsible for ensuring medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions. · ...

This Utilization Review Registered Nurse position at Mount Sinai Medical Center involves coordinating participant care and ensuring timely discharges. Responsibilities include monitoring service utilization, working with providers to ensure appropriate medical care levels for par ...

The job involves identifying inpatient admissions by utilizing census data, hospital admission logs, inquiries with ER departments, direct notifications from PCPs or family members, and contacting hospitalist programs. The candidate will initiate concurrent reviews within one wor ...

· Company Description · HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest a ...

The Medical Review Nurse II primarily performs medical claims audit reviews. As a MR Nurse, you will join a team of experienced medical auditors and coders performing retrospective and prepayment audits on claims for Government and Commercial Payers. ...

The Medical Review Nurse II primarily performs medical claims audit reviews in a fast-paced dynamic environment working remotely with a multi-location team. · ...

Perform medical claims audit reviews as part of a team of experienced medical auditors and coders. · ...

The Medical Review Nurse II primarily performs medical claims audit reviews. · ...

The Medical Review Nurse II performs medical claims audit reviews remotely in a fast-paced environment. · ...

+ Telephonically review inpatient admissions to assure appropriate level of care and medical necessity · + Act as clinical resources to referral staff and make appropriate referrals. · + Provide patient and provider education. · Requirements:Current, active RN in the state of Flo ...

Leads and provides consultation to Nicklaus Children Health System (NCHS) in the clinical review evaluation and procurement of products leads multi-disciplinary teams to decrease product variation utilization and costs through the development of consensus supply utilization progr ...

Physician Assistant / Advanced Nurse Practitioner · In Mount Sinai's pursuit of clinical excellence, we seek a skilled Physician Assistant (PA) / Advanced Nurse Practitioner (APRN). This role is part of our Gastroenterology team at our Miami Beach location. · Fully qualified as a ...

We aim to improve employability and inspire lifelong career growth thereby improving the lives of individuals in our community.The Practical Nursing Program Director will oversee ensure quality effectiveness of faculty-led instruction while delivering high-quality education to nu ...

+We are seeking an experienced Nurse to start up the Practical Nurse Program. · + · +Exciting opportunity for an entrepreneurial spirit · +FVI School of Nursing and Technology is a private, post-secondary institution providing associate and diploma career programs in nursing, all ...

The Dietary Manager is responsible for partnering with the Dietitian to plan, organize, develop and direct the overall operation of the Dietary Department in accordance with current, federal, state and local standards guidelines and regulations governing our facility. · ...