... not limited to: utilization review, case documentation, payer relationships, regulatory ... Must have Registered Nurse license or Master's Degree. Experience: 5-7 yrs acute inpatient ...
... not limited to: utilization review, case documentation, payer relationships, regulatory ... Must have Registered Nurse license or Master's Degree. Experience: 5-7 yrs acute inpatient ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... Utilization Review and Medical Necessity * Concurrent Review and Length of Stay Management
UTILIZATION REVIEW RN
Seymour, IN · On-site
Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... Utilization Review and Medical Necessity * Concurrent Review and Length of Stay Management
UTILIZATION REVIEW RN
Seymour, IN · On-site
Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... DUTIES 1. Utilization Review and Medical Necessity 2. Concurrent Review and Length of Stay ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... DUTIES 1. Utilization Review and Medical Necessity 2. Concurrent Review and Length of Stay ...
... Nursing or Psychology required. Master's degree preferred. Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management ...
... Nursing or Psychology required. Master's degree preferred. Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management ...
... Nursing or Psychology required. Master's degree preferred. Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management ...
... Nursing or Psychology required. Master's degree preferred. Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management ...
... Nursing or Psychology required. Master's degree preferred. Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management ...
... Nursing or Psychology required. Master's degree preferred. Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management ...
... Nursing or Psychology required. Master's degree preferred. Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management ...
... Nursing or Psychology required. Master's degree preferred. Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management ...
... Nursing or Psychology required. Master's degree preferred. Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management ...
... Nursing or Psychology required. Master's degree preferred. Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management ...
... Nursing or Psychology required. Master's degree preferred. Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management ...
... Nursing or Psychology required. Master's degree preferred. Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... UR contacts external case managers/managed care organizations for certification of insurance ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... UR contacts external case managers/managed care organizations for certification of insurance ...
UR contacts external case managers/managed care organizations for certification of insurance ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
UR contacts external case managers/managed care organizations for certification of insurance ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... UR contacts external case managers/managed care organizations for certification of insurance ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... UR contacts external case managers/managed care organizations for certification of insurance ...
UR contacts external case managers/managed care organizations for certification of insurance ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
UR contacts external case managers/managed care organizations for certification of insurance ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
RN Case Manager
Indianapolis, IN · On-site
Description Our Registered Nurse Case Managers (RNCM) have been called to care when they're needed ... case management/utilization review experience preferred. • OASIS experience preferred. • ...
RN Case Manager
Indianapolis, IN · On-site
Description Our Registered Nurse Case Managers (RNCM) have been called to care when they're needed ... case management/utilization review experience preferred. • OASIS experience preferred. • ...
RN Case Manager
Indianapolis, IN · On-site
Description Our Registered Nurse Case Managers (RNCM) have been called to care when they're needed ... case management/utilization review experience preferred. • OASIS experience preferred. • ...
RN Case Manager
Indianapolis, IN · On-site
Description Our Registered Nurse Case Managers (RNCM) have been called to care when they're needed ... case management/utilization review experience preferred. • OASIS experience preferred. • ...
RN Case Manager
Indianapolis, IN · On-site
Description Our Registered Nurse Case Managers (RNCM) have been called to care when they're needed ... case management/utilization review experience preferred. • OASIS experience preferred. • ...
RN Case Manager
Indianapolis, IN · On-site
Description Our Registered Nurse Case Managers (RNCM) have been called to care when they're needed ... case management/utilization review experience preferred. • OASIS experience preferred. • ...
RN Case Manager
Greenwood, IN · On-site
Description Our Registered Nurse Case Managers (RNCM) have been called to care when they're needed ... case management/utilization review experience preferred. • OASIS experience preferred. • ...
RN Case Manager
Greenwood, IN · On-site
Description Our Registered Nurse Case Managers (RNCM) have been called to care when they're needed ... case management/utilization review experience preferred. • OASIS experience preferred. • ...
RN Case Manager
Greenwood, IN · On-site
Description Our Registered Nurse Case Managers (RNCM) have been called to care when they're needed ... case management/utilization review experience preferred. • OASIS experience preferred. • ...
RN Case Manager
Greenwood, IN · On-site
Description Our Registered Nurse Case Managers (RNCM) have been called to care when they're needed ... case management/utilization review experience preferred. • OASIS experience preferred. • ...
RN Case Manager
Greenwood, IN · On-site
Description Our Registered Nurse Case Managers (RNCM) have been called to care when they're needed ... case management/utilization review experience preferred. • OASIS experience preferred. • ...
RN Case Manager
Greenwood, IN · On-site
Description Our Registered Nurse Case Managers (RNCM) have been called to care when they're needed ... case management/utilization review experience preferred. • OASIS experience preferred. • ...
Weekend Option RN Case Manager - Community Heart & Vascular Community Health Network was created by ... utilization review and management and discharge planning. Has accountability for the care ...
Weekend Option RN Case Manager - Community Heart & Vascular Community Health Network was created by ... utilization review and management and discharge planning. Has accountability for the care ...
Case Manager Utilization Review Nurse information
What is a case manager utilization review nurse?
A Case Manager Utilization Review Nurse is a registered nurse who evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, coordinate with healthcare providers, and ensure that treatments meet established guidelines and insurance requirements. Their goal is to optimize patient outcomes while controlling healthcare costs and ensuring compliance with regulations. These nurses also help facilitate communication between patients, providers, and payers to support effective care management.
How does a case manager utilization review nurse typically collaborate with physicians and other healthcare providers?
Case Manager Utilization Review Nurses regularly work with physicians, social workers, and other healthcare professionals to ensure patients receive appropriate care while managing resource utilization. They often participate in interdisciplinary team meetings to discuss care plans, review patient progress, and address any barriers to discharge. Building strong communication channels and maintaining up-to-date clinical knowledge are essential, as nurses must advocate for patients while also supporting evidence-based practices and regulatory compliance. This collaborative environment helps streamline patient care and optimize outcomes.
What are the key skills and qualifications needed to thrive as a case manager utilization review nurse, and why are they important?
To excel as a Case Manager Utilization Review Nurse, you need a solid background in nursing, strong clinical assessment skills, and a valid RN license, often with case management certification. Familiarity with utilization review software, electronic health record (EHR) systems, and knowledge of insurance and regulatory guidelines is essential. Exceptional communication, critical thinking, and negotiation abilities set top performers apart in this role. These qualifications ensure effective patient advocacy, cost-effective care, and compliance with healthcare standards.
What is the difference between Case Manager Utilization Review Nurse vs Case Manager?
| Aspect | Case Manager Utilization Review Nurse | Case Manager |
|---|---|---|
| Credentials | RN license, certification in utilization review (e.g., URAC) | RN license, case management certification (e.g., CCM) |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Hospitals, community health, insurance providers |
| Primary Focus | Reviewing medical necessity and appropriateness of care | Coordinating patient care and discharge planning |
While both roles involve patient care coordination, the Case Manager Utilization Review Nurse primarily focuses on reviewing medical necessity and insurance approvals, whereas the Case Manager handles broader patient care coordination and discharge planning. Both roles require nursing credentials and are vital in healthcare settings, but their specific responsibilities differ.
What are popular job titles related to Case Manager Utilization Review Nurse jobs in Indiana?
For Case Manager Utilization Review Nurse jobs in Indiana, the most frequently searched job titles are:
- Part Time Utilization Review Nurse
- Night Utilization Review Nurse
- Remote Utilization Review Social Worker
- Per Diem Utilization Review Nurse
- Remote Utilization Review Nurse
- Remote Medical Record Review Nurse
- Flex Schedule Remote Utilization Review Nurse
- Registered Nurse Utilization Review
- Remote Utilization Review Rn
- Optum Clinical Claim Review Nurse
What job categories do people searching Case Manager Utilization Review Nurse jobs in Indiana look for?
The top searched job categories for Case Manager Utilization Review Nurse jobs in Indiana are:
What cities in Indiana are hiring for Case Manager Utilization Review Nurse jobs?
Cities in Indiana with the most Case Manager Utilization Review Nurse job openings:
Universal Health Services rating
6.9
Based on 254 frontline employees who took The Breakroom Quiz
453rd of 893 rated healthcare providers
Job description
Responsibilities
The Utilization Management Manager oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management and department administration. Supports the overall success of the hospital and promotes patient satisfaction, regulatory compliance and optimal reimbursement.
Qualifications
QUALIFICATIONS
Education :Must have Registered Nurse license or Master's Degree.
Experience: 5-7 yrs acute inpatient psychiatric setting as a treatment team member experience or 3-5 years of experience in utilization management for both mental health and substance abuse behavioral health disorders experience.
Work Location: In person
The Utilization Management Manager oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management and department administration. Supports the overall success of the hospital and promotes patient satisfaction, regulatory compliance and optimal reimbursement.
Qualifications
QUALIFICATIONS
Education :Must have Registered Nurse license or Master's Degree.
Experience: 5-7 yrs acute inpatient psychiatric setting as a treatment team member experience or 3-5 years of experience in utilization management for both mental health and substance abuse behavioral health disorders experience.
Work Location: In person
What Universal Health Services employees say
Pay
Benefits
Hours and flexibility
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Get the full story on Breakroom
About Universal Health Services
Sourced by ZipRecruiter
Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
King of Prussia, PA, US