Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews.
Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews.
Job Title Utilization Management Nurse Utilization management is the analysis of the medical necessity, acute care appropriateness, and efficiency of medical services and procedures in the hospital ...
Job Title Utilization Management Nurse Utilization management is the analysis of the medical necessity, acute care appropriateness, and efficiency of medical services and procedures in the hospital ...
Overview Utilization management is the analysis of the medical necessity, acute care ... Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) or Licensed Registered Nurse ...
Overview Utilization management is the analysis of the medical necessity, acute care ... Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) or Licensed Registered Nurse ...
Overview Utilization management is the analysis of the medical necessity, acute care ... Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) or Licensed Registered Nurse ...
Overview Utilization management is the analysis of the medical necessity, acute care ... Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) or Licensed Registered Nurse ...
Quality Utilization Reviewer I
Birmingham, AL · On-site
... of the UR Manager & Department Director, UR Reviewer 1 with LPN/RN licensure may advance to ... Utilization review experience preferred Licensures, Certifications, and/or Registries * Current AL ...
Quality Utilization Reviewer I
Birmingham, AL · On-site
... of the UR Manager & Department Director, UR Reviewer 1 with LPN/RN licensure may advance to ... Utilization review experience preferred Licensures, Certifications, and/or Registries * Current AL ...
Quality Utilization Reviewer I
Birmingham, AL · On-site
... of the UR Manager & Department Director, UR Reviewer 1 with LPN/RN licensure may advance to ... Utilization review experience preferred Licensures, Certifications, and/or Registries * Current AL ...
Quality Utilization Reviewer I
Birmingham, AL · On-site
... of the UR Manager & Department Director, UR Reviewer 1 with LPN/RN licensure may advance to ... Utilization review experience preferred Licensures, Certifications, and/or Registries * Current AL ...
Minimum 2 years experience as an RN * Minimum of at least 2 years as care management and/or utilization management experience preferred. * Minimum of 2 years of Med Surgical experience required;
Minimum 2 years experience as an RN * Minimum of at least 2 years as care management and/or utilization management experience preferred. * Minimum of 2 years of Med Surgical experience required;
Minimum 2 years experience as an RN * Minimum of at least 2 years as care management and/or utilization management experience preferred. * Minimum of 2 years of Med Surgical experience required;
Minimum 2 years experience as an RN * Minimum of at least 2 years as care management and/or utilization management experience preferred. * Minimum of 2 years of Med Surgical experience required;
Utilization Review Care Manager
Tuscaloosa, AL · On-site
$60 - $80/hr
Minimum 2 years experience as an RN * Minimum of at least 2 years as care management and/or utilization management experience preferred. * Minimum of 2 years of Med Surgical experience required;
Utilization Review Care Manager
Tuscaloosa, AL · On-site
$60 - $80/hr
Minimum 2 years experience as an RN * Minimum of at least 2 years as care management and/or utilization management experience preferred. * Minimum of 2 years of Med Surgical experience required;
Identifies and reports Quality and Risk Management concerns. DCH Standards: * Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance ...
Identifies and reports Quality and Risk Management concerns. DCH Standards: * Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance ...
Minimum 2 years experience as an RN * Minimum of at least 2 years as care management and/or utilization management experience preferred. * Minimum of 2 years of Med Surgical experience required;
Minimum 2 years experience as an RN * Minimum of at least 2 years as care management and/or utilization management experience preferred. * Minimum of 2 years of Med Surgical experience required;
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Utilization Review Technician
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Provides clinical and nurse consultations * Identifies opportunities to implement best practices ... Performs utilization review and case management support on complex members * Provides support over ...
Provides clinical and nurse consultations * Identifies opportunities to implement best practices ... Performs utilization review and case management support on complex members * Provides support over ...
Utilization Review * Schedule: PRN Days * Work Location: UAB ST Vincent's Birmingham * Benefits for ... Provide case management and/or consultation for complex cases. * Assist departmental staff with ...
Utilization Review * Schedule: PRN Days * Work Location: UAB ST Vincent's Birmingham * Benefits for ... Provide case management and/or consultation for complex cases. * Assist departmental staff with ...
Utilization Review * Schedule: PRN Days * Work Location: UAB ST Vincent's Birmingham * Benefits for ... Provide case management and/or consultation for complex cases. * Assist departmental staff with ...
Utilization Review * Schedule: PRN Days * Work Location: UAB ST Vincent's Birmingham * Benefits for ... Provide case management and/or consultation for complex cases. * Assist departmental staff with ...
... and manage multiple priorities, and to adapt to a rapidly changing environment. Key ... Assumes accountability for appropriate utilization of resources. * Performs other duties as ...
... and manage multiple priorities, and to adapt to a rapidly changing environment. Key ... Assumes accountability for appropriate utilization of resources. * Performs other duties as ...
... priorities and manage multiple priorities, and to adapt to a rapidly changing environment ... Assumes accountability for appropriate utilization of resources. * Performs other duties as ...
... priorities and manage multiple priorities, and to adapt to a rapidly changing environment ... Assumes accountability for appropriate utilization of resources. * Performs other duties as ...
... priorities and manage multiple priorities, and to adapt to a rapidly changing environment ... Assumes accountability for appropriate utilization of resources. * Performs other duties as ...
... priorities and manage multiple priorities, and to adapt to a rapidly changing environment ... Assumes accountability for appropriate utilization of resources. * Performs other duties as ...
... priorities and manage multiple priorities, and to adapt to a rapidly changing environment ... Assumes accountability for appropriate utilization of resources. * Performs other duties as ...
... priorities and manage multiple priorities, and to adapt to a rapidly changing environment ... Assumes accountability for appropriate utilization of resources. * Performs other duties as ...
... Utilization Review and Discharge Planning. Including but not limited to daily review of medical ... Minimum of three years nursing experience required. Three years' experience in case management or ...
... Utilization Review and Discharge Planning. Including but not limited to daily review of medical ... Minimum of three years nursing experience required. Three years' experience in case management or ...
Apprentice Utilization Management Nurse information
What is an apprentice utilization management nurse?
An Apprentice Utilization Management Nurse is a nursing professional in training who assists with the review and evaluation of healthcare services to ensure they are medically necessary and cost-effective. They work under the supervision of experienced utilization management nurses and follow established guidelines to assess patient care plans, medical records, and insurance policies. Their role is crucial in helping healthcare organizations maintain quality care while managing costs, and they may interact with physicians, patients, and insurance companies to clarify or justify treatment decisions. As apprentices, they are gaining hands-on experience to develop their skills and knowledge in utilization management.
What are the key skills and qualifications needed to thrive as an apprentice utilization management nurse, and why are they important?
To thrive as an Apprentice Utilization Management Nurse, you need a foundational understanding of nursing principles, strong analytical skills, and typically an RN license or progression toward one. Familiarity with utilization management software, electronic health records (EHR), and knowledge of insurance guidelines such as Medicare or Medicaid are often required. Attention to detail, critical thinking, and effective communication are essential soft skills for collaborating with healthcare teams and conveying clinical information. These competencies ensure accurate patient care reviews, compliance with regulations, and effective support in healthcare cost management.
What are some common challenges faced by apprentice utilization management nurses, and how can they be addressed?
Apprentice Utilization Management Nurses often encounter challenges such as learning to interpret complex medical records, understanding insurance policies, and adhering to strict regulatory guidelines. Balancing patient advocacy with cost-effective care decisions can also be demanding. These challenges can be addressed by actively participating in mentorship programs, seeking regular feedback from experienced colleagues, and utilizing ongoing training resources provided by employers. Developing strong communication and organizational skills will also help manage the workload and foster effective collaboration with physicians, case managers, and insurance representatives.
What is the difference between Apprentice Utilization Management Nurse vs Utilization Management Nurse?
| Aspect | Apprentice Utilization Management Nurse | Utilization Management Nurse |
|---|---|---|
| Credentials | Licensed RN, in training or early certification stage | Licensed RN with certification in utilization review |
| Work Environment | Supervised training setting, often in healthcare or insurance companies | Independent review in healthcare or insurance organizations |
| Job Responsibilities | Assisting with case reviews, learning utilization review processes | Conducting case assessments, making coverage decisions |
The Apprentice Utilization Management Nurse is in training, focusing on learning review procedures under supervision, while the Utilization Management Nurse is fully qualified, responsible for independent case evaluations and decision-making. The apprentice role is a stepping stone toward becoming a licensed Utilization Management Nurse.
What are the most commonly searched types of Utilization Management Nurse jobs in Alabama?
The most popular types of Utilization Management Nurse jobs in Alabama are:
Job description
Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews.
About Blue Eagle Consulting
Sourced by ZipRecruiter
Industry
It services
Company size
11 - 50 Employees
Headquarters location
Birmingham, AL, US
Year founded
2004