Reviews patient chart to ensure patient continues to meet medical necessity. * Documentation of all ... Performs verbal/fax clinical review with payer as determined by nursing judgment and/or ...
Reviews patient chart to ensure patient continues to meet medical necessity. * Documentation of all ... Performs verbal/fax clinical review with payer as determined by nursing judgment and/or ...
Utilization Review Nurse
Salt Lake City, UT · On-site
Retirement
Reviews patient chart to ensure patient continues to meet medical necessity. * Documentation of all ... Performs verbal/fax clinical review with payer as determined by nursing judgment and/or ...
Utilization Review Nurse
Salt Lake City, UT · On-site
Retirement
Reviews patient chart to ensure patient continues to meet medical necessity. * Documentation of all ... Performs verbal/fax clinical review with payer as determined by nursing judgment and/or ...
Nurse
Randallstown, MD · On-site
The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to ...
Quick apply
Nurse
Randallstown, MD · On-site
The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to ...
LPN/RN HEDIS Review Nurse
$22 - $36/hr
Medical
Dental
Vision
Retirement
PTO
Candidates must have 2-3 years of experience as a field chart reviewer. * Current RN/LPN license in the state of Florida. * Must have HEDIS experience and field QA chart review data abstraction ...
LPN/RN HEDIS Review Nurse
$22 - $36/hr
Medical
Dental
Vision
Retirement
PTO
Candidates must have 2-3 years of experience as a field chart reviewer. * Current RN/LPN license in the state of Florida. * Must have HEDIS experience and field QA chart review data abstraction ...
Utilization Review Nurse
Murray, UT · On-site +1
Reviews patient chart to ensure patient continues to meet medical necessity. * Documentation of all ... Performs verbal/fax clinical review with payer as determined by nursing judgment and/or ...
Utilization Review Nurse
Murray, UT · On-site +1
Reviews patient chart to ensure patient continues to meet medical necessity. * Documentation of all ... Performs verbal/fax clinical review with payer as determined by nursing judgment and/or ...
Reviews patient chart to ensure patient continues to meet medical necessity. * Documentation of all ... Performs verbal/fax clinical review with payer as determined by nursing judgment and/or ...
Reviews patient chart to ensure patient continues to meet medical necessity. * Documentation of all ... Performs verbal/fax clinical review with payer as determined by nursing judgment and/or ...
LPN/RN HEDIS Review Nurse
$22 - $36/hr
Medical
Dental
Vision
Retirement
PTO
Candidates must have 2-3 years of experience as a field chart reviewer. * Current RN/LPN license in the state of Florida. * Must have HEDIS experience and field QA chart review data abstraction ...
LPN/RN HEDIS Review Nurse
$22 - $36/hr
Medical
Dental
Vision
Retirement
PTO
Candidates must have 2-3 years of experience as a field chart reviewer. * Current RN/LPN license in the state of Florida. * Must have HEDIS experience and field QA chart review data abstraction ...
Utilization Review RN - Per Diem *IMPORTANT NOTE: In lieu of benefits due to "per diem" status, 15 ... Performs clinically orientated medical chart reviews and other administrative tasks to meet the ...
Utilization Review RN - Per Diem *IMPORTANT NOTE: In lieu of benefits due to "per diem" status, 15 ... Performs clinically orientated medical chart reviews and other administrative tasks to meet the ...
Utilization Review RN - Per Diem* *IMPORTANT NOTE: In lieu of benefits due to "per diem" status, 15 ... Performs clinically orientated medical chart reviews and other administrative tasks to meet the ...
Quick apply
Utilization Review RN - Per Diem* *IMPORTANT NOTE: In lieu of benefits due to "per diem" status, 15 ... Performs clinically orientated medical chart reviews and other administrative tasks to meet the ...
Utilization Review RN - Per Diem *IMPORTANT NOTE: In lieu of benefits due to "per diem" status, 15 ... Performs clinically orientated medical chart reviews and other administrative tasks to meet the ...
Utilization Review RN - Per Diem *IMPORTANT NOTE: In lieu of benefits due to "per diem" status, 15 ... Performs clinically orientated medical chart reviews and other administrative tasks to meet the ...
Utilization Review RN - Per Diem* *IMPORTANT NOTE: In lieu of benefits due to "per diem" status, 15 ... Performs clinically orientated medical chart reviews and other administrative tasks to meet the ...
Quick apply
Utilization Review RN - Per Diem* *IMPORTANT NOTE: In lieu of benefits due to "per diem" status, 15 ... Performs clinically orientated medical chart reviews and other administrative tasks to meet the ...
Utilization Review RN - Per Diem* *IMPORTANT NOTE: In lieu of benefits due to "per diem" status, 15 ... Performs clinically orientated medical chart reviews and other administrative tasks to meet the ...
Utilization Review RN - Per Diem* *IMPORTANT NOTE: In lieu of benefits due to "per diem" status, 15 ... Performs clinically orientated medical chart reviews and other administrative tasks to meet the ...
Registered Nurse; Licensure: Ohio Nursing License. * Training and Experience * 3 years clinical ... Ability to assess medical necessity and progress by chart review. * Preferred: Certification in ...
Registered Nurse; Licensure: Ohio Nursing License. * Training and Experience * 3 years clinical ... Ability to assess medical necessity and progress by chart review. * Preferred: Certification in ...
Licensed Practical Nurse (LPN) Chronic Care Management (CCM) Chart Review SNF Healthcare
$25.50 - $34.50/hr
Conduct comprehensive chart reviews to support care plan oversight * Document time spent and ... Active and unrestricted LPN license * Experience in long-term care (LTC), skilled nursing facility ...
Quick apply
Licensed Practical Nurse (LPN) Chronic Care Management (CCM) Chart Review SNF Healthcare
$25.50 - $34.50/hr
Conduct comprehensive chart reviews to support care plan oversight * Document time spent and ... Active and unrestricted LPN license * Experience in long-term care (LTC), skilled nursing facility ...
Pool Utilization Review Registered Nurse, Case Management, Per Diem, Shift Varies (Rotating Weeke...
Boca Raton, FL · On-site
$47/hr
The purpose of this position is to conduct initial, concurrent, retrospective chart review for ... Registered Nurse. Additional Qualifications: * RNs hired prior to 2/2012 (10/1/2017 at Bethesda or ...
Pool Utilization Review Registered Nurse, Case Management, Per Diem, Shift Varies (Rotating Weeke...
Boca Raton, FL · On-site
$47/hr
The purpose of this position is to conduct initial, concurrent, retrospective chart review for ... Registered Nurse. Additional Qualifications: * RNs hired prior to 2/2012 (10/1/2017 at Bethesda or ...
Utilization Review Nurse - Part Time - Shift
$43.51 - $68.56/hr
Medical
Dental
Vision
Life
Retirement
PTO
Incumbents perform clinically oriented medical chart reviews and other administrative tasks to meet ... The Utilization Review Nurse classification ranges from less experienced nurses, who will perform ...
Utilization Review Nurse - Part Time - Shift
$43.51 - $68.56/hr
Medical
Dental
Vision
Life
Retirement
PTO
Incumbents perform clinically oriented medical chart reviews and other administrative tasks to meet ... The Utilization Review Nurse classification ranges from less experienced nurses, who will perform ...
Utilization Review Nurse - Case Management - Part Time - Shift
Bakersfield, CA · On-site
$43.51 - $68.56/hr
Medical
Dental
Vision
Life
Retirement
PTO
Incumbents perform clinically oriented medical chart reviews and other administrative tasks to meet ... The Utilization Review Nurse classification ranges from less experienced nurses, who will perform ...
Utilization Review Nurse - Case Management - Part Time - Shift
Bakersfield, CA · On-site
$43.51 - $68.56/hr
Medical
Dental
Vision
Life
Retirement
PTO
Incumbents perform clinically oriented medical chart reviews and other administrative tasks to meet ... The Utilization Review Nurse classification ranges from less experienced nurses, who will perform ...
Utilization Review Nurse - Case Management - Part Time - Shift
Bakersfield, CA · On-site
$43.51 - $68.56/hr
Medical
Dental
Vision
Life
Retirement
PTO
Incumbents perform clinically oriented medical chart reviews and other administrative tasks to meet ... The Utilization Review Nurse classification ranges from less experienced nurses, who will perform ...
Utilization Review Nurse - Case Management - Part Time - Shift
Bakersfield, CA · On-site
$43.51 - $68.56/hr
Medical
Dental
Vision
Life
Retirement
PTO
Incumbents perform clinically oriented medical chart reviews and other administrative tasks to meet ... The Utilization Review Nurse classification ranges from less experienced nurses, who will perform ...
Clinical Reviewer (RN)
Jericho, NY · On-site
$38.46 - $43.27/hr
This includes chart review, complete detailed electronic data worksheets. * Act as a resource for ... A bachelor's degree in Nursing OR graduate of an approved Registered Professional Nurses training ...
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Clinical Reviewer (RN)
Jericho, NY · On-site
$38.46 - $43.27/hr
This includes chart review, complete detailed electronic data worksheets. * Act as a resource for ... A bachelor's degree in Nursing OR graduate of an approved Registered Professional Nurses training ...
... patient chart, clinical nursing judgement, and discussions with the attending physician and/or physician advisor. The UR RN (PRN) will perform utilization review by completing a timely and ...
New
... patient chart, clinical nursing judgement, and discussions with the attending physician and/or physician advisor. The UR RN (PRN) will perform utilization review by completing a timely and ...
New
Entry Level Chart Review Nurse information
See salary details
$17.31 - $21.68
3% of jobs
$21.68 - $26.05
7% of jobs
$29.33 is the 25th percentile. Wages below this are outliers.
$26.05 - $30.42
20% of jobs
The median wage is $34.13 / hr.
$30.42 - $34.79
24% of jobs
$34.79 - $39.16
14% of jobs
$41.84 is the 75th percentile. Wages above this are outliers.
$39.16 - $43.53
11% of jobs
$43.53 - $47.90
7% of jobs
$47.90 - $52.27
5% of jobs
$52.27 - $56.64
3% of jobs
$56.64 - $61.01
3% of jobs
$61.01 - $65.38
2% of jobs
$17
$38
$65
How much do entry level chart review nurse jobs pay per hour?
What are the most commonly searched types of Chart Review Nurse jobs?
The most popular types of Chart Review Nurse jobs are:
Full-time
Re-posted 27 days ago
University Of Utah Health rating
7.7
Based on 142 frontline employees who took The Breakroom Quiz
157th of 887 rated healthcare providers
Job description
As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA
This position is responsible for maintaining the financial integrity of both the patient and the organization through the provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such care; achieved via managing the cost of care while providing timely and accurate information to third party payers and medical care team. This position may be required to access and administer medications within their scope of practice and according to state law.
Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.
Responsibilities
Essential Functions
- Applies approved utilization criteria to monitor appropriateness of admissions with associated levels of care and continued stay review.
- Communication to third-party payers for initial and concurrent clinical review.
- Reviews patient chart to ensure patient continues to meet medical necessity.
- Documentation of all actions and information shared with care team members or third-party payer.
- Alerts and discusses with physician/provider and case manager/discharge planner when patient no longer meets medical necessity criteria for the inpatient stay.
- Discusses with physicians the appropriateness of resource utilization.
- Tracks length of stay (LOS) and resource utilization to identify at risk patients.
- Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources.
- Performs verbal/fax clinical review with payer as determined by nursing judgment and/or collaboration with the payer per university contractual obligation.
- Participant in UR Committee as needed.
- Collects data on variances in LOS, avoidable days, costs/barriers to discharge/transition and denied days.
- Prepares appeals on denied cases when appropriate.
- At the discretion of department operational and patient care needs, this position is required to work rotating schedules, which may include variable hours, weekends, nights, and holidays to meet the staffing and patient care demands of a 24/7 complex health system. Regular, reliable, and punctual attendance during assigned shifts is considered an essential function of the role.
- Demonstrated availability to work variable and rotating shifts, including nights, weekends, and holidays, in a 24/7 patient care environment.
- Ability to perform the essential functions of the job as outlined above.
- Demonstrated team leadership, relationship building, critical analysis, and written and verbal communication skills.
- Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria.
- The ability to demonstrate knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual.
- Ability to work autonomously and as a team member.
Qualifications
Required
- One year Utilization Review or Case Management experience.
- Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the interstate compact if switching residency to State of Utah. Must maintain current Interstate Compact (multi-state) license if residency is not being changed to Utah.
Qualifications (Preferred)
Preferred
- Basic Life Support Health Care Provider card.
- Proficiency in application of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes.
- Utilization Review Certification designation.
- Knowledge of CMS Regulations.
Employee must be able to meet the following requirements with or without an accommodation.
- This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions. This position does not provide care to patients.
Physical Requirements
Color Determination, Listening, Manual Dexterity, Sitting, Speaking, Standing, Walking
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