Active RN license (state-specific requirement applies) * Minimum of 2 years of acute care nursing experience * Prior utilization review, case management, or payer review experience preferred * Strong ...
Active RN license (state-specific requirement applies) * Minimum of 2 years of acute care nursing experience * Prior utilization review, case management, or payer review experience preferred * Strong ...
Active RN license (state-specific requirement applies) * Minimum of 2 years of acute care nursing experience * Prior utilization review, case management, or payer review experience preferred * Strong ...
Active RN license (state-specific requirement applies) * Minimum of 2 years of acute care nursing experience * Prior utilization review, case management, or payer review experience preferred * Strong ...
Active RN license (state-specific requirement applies) * Minimum of 2 years of acute care nursing experience * Prior utilization review, case management, or payer review experience preferred * Strong ...
Active RN license (state-specific requirement applies) * Minimum of 2 years of acute care nursing experience * Prior utilization review, case management, or payer review experience preferred * Strong ...
Active RN license (state-specific requirement applies) * Minimum of 2 years of acute care nursing experience * Prior utilization review, case management, or payer review experience preferred * Strong ...
Active RN license (state-specific requirement applies) * Minimum of 2 years of acute care nursing experience * Prior utilization review, case management, or payer review experience preferred * Strong ...
Coordinate and support the hospital's Utilization Review and Case Management program to ensure ... Registered Nurse (RN) or Licensed Practical Nurse (LPN) in the state of practice required.
Coordinate and support the hospital's Utilization Review and Case Management program to ensure ... Registered Nurse (RN) or Licensed Practical Nurse (LPN) in the state of practice required.
Utilization Review RN
Indianapolis, IN · On-site
... reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts. Qualifications * Must have clear and active RN license in the state of IN * AS ...
Utilization Review RN
Indianapolis, IN · On-site
... reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts. Qualifications * Must have clear and active RN license in the state of IN * AS ...
Utilization Review RN
$30 - $34/hr
Expected to review 20 cases a day with a 95% accuracy rate. Responsible for collaborating with ... Must have clear and active RN license in the state of IN * 2 years of experience in a acute care ...
Utilization Review RN
$30 - $34/hr
Expected to review 20 cases a day with a 95% accuracy rate. Responsible for collaborating with ... Must have clear and active RN license in the state of IN * 2 years of experience in a acute care ...
OASIS Review Nurse
Noblesville, IN · On-site
The Utilization Review Nurse is responsible for reviewing patient assessments to assist the Quality ... Must possess current license as a Registered Nurse with the State of Indiana Health Professions ...
OASIS Review Nurse
Noblesville, IN · On-site
The Utilization Review Nurse is responsible for reviewing patient assessments to assist the Quality ... Must possess current license as a Registered Nurse with the State of Indiana Health Professions ...
... the Utilization Review nurses' team to ensure timely patient progression through the episode/plan of care • Documents and maintains pre-certification/authorization information accessible by the ...
... the Utilization Review nurses' team to ensure timely patient progression through the episode/plan of care • Documents and maintains pre-certification/authorization information accessible by the ...
Communicates and negotiates with payers to obtain approvals for the appropriate care level Maintains open collaborative active communication with the Utilization Review nurses' team to ensure timely ...
Communicates and negotiates with payers to obtain approvals for the appropriate care level Maintains open collaborative active communication with the Utilization Review nurses' team to ensure timely ...
Travel Nurse Manager (Full Time)
$90K - $95K/yr
Registered nurse, rn, nurse, nurse consultant, lpn, wellness nurse, utilization review nurse, nurse rn, nursing, licensed practical nurse, registered nurse, assisted living LPN, day, night, shift ...
Travel Nurse Manager (Full Time)
$90K - $95K/yr
Registered nurse, rn, nurse, nurse consultant, lpn, wellness nurse, utilization review nurse, nurse rn, nursing, licensed practical nurse, registered nurse, assisted living LPN, day, night, shift ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
Travel Nurse Manager (Full Time)
Zionsville, IN · On-site
$90K - $95K/yr
Registered nurse, rn, nurse, nurse consultant, lpn, wellness nurse, utilization review nurse, nurse rn, nursing, licensed practical nurse, registered nurse, assisted living LPN, day, night, shift ...
Travel Nurse Manager (Full Time)
Zionsville, IN · On-site
$90K - $95K/yr
Registered nurse, rn, nurse, nurse consultant, lpn, wellness nurse, utilization review nurse, nurse rn, nursing, licensed practical nurse, registered nurse, assisted living LPN, day, night, shift ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
OASIS Review Nurse
Noblesville, IN · Hybrid
The Utilization Review Nurse is responsible for reviewing patient assessments to assist the Quality Improvement department in identifying areas for improvement to maximize reimbursement. * Reviews ...
OASIS Review Nurse
Noblesville, IN · Hybrid
The Utilization Review Nurse is responsible for reviewing patient assessments to assist the Quality Improvement department in identifying areas for improvement to maximize reimbursement. * Reviews ...
Utilization Management Nurse
Columbus, IN · On-site
This position is reserved for a licensed Registered Nurse who will perform the Utilization ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Utilization Management Nurse
Columbus, IN · On-site
This position is reserved for a licensed Registered Nurse who will perform the Utilization ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Entry Level Rn Utilization Review Nurse information
What are popular job titles related to Entry Level Rn Utilization Review Nurse jobs in Indiana? For Entry Level Rn Utilization Review Nurse jobs in Indiana, the most frequently searched job titles are:
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What job categories do people searching Entry Level Rn Utilization Review Nurse jobs in Indiana look for? The top searched job categories for Entry Level Rn Utilization Review Nurse jobs in Indiana are:
What cities in Indiana are hiring for Entry Level Rn Utilization Review Nurse jobs? Cities in Indiana with the most Entry Level Rn Utilization Review Nurse job openings:
Part-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 11 days ago
Trinity Health rating
6.5
Based on 348 frontline employees who took The Breakroom Quiz
593rd of 864 rated healthcare providers
Job description
Employment Type:Part timeShift:Rotating ShiftDescription:This is a remote position but will need onsite training in Mishawaka Indiana.
Shift: PRN/Days - 8 hr shift
Considering local candidates only!!!
Shift: PRN/Days - 8 hr shift
Considering local candidates only!!!
Why Choose Saint Joseph Health System?
At Saint Joseph Health System, our values guide every decision we make. Even when challenges arise, we remain committed to our mission: caring for every person who needs us. We invest in our people, our technology, and our capabilities so we can continue delivering exceptional, compassionate care to our communities.
Tuition reimbursement for all full-time and part-time colleagues starting on day one
Comprehensive benefits beginning day one (Medical, Dental, Vision, PTO, Life Insurance, STD/LTD, and more)
Retirement savings plan with employer match
Generous paid time off program plus 7 paid holidays
No mandatory overtime
Employee referral incentive program
Access to state-of-the-art equipment, unlimited CEUs, and a supportive team-focused work environment
- Conduct clinical reviews of patient records to evaluate medical necessity, appropriateness of admission, treatment, and length of stay across all payor types
- Apply standardized criteria, regulatory guidelines, and insurance requirements to support reimbursement and compliance
- Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate resource utilization and care planning
- Review admissions and ongoing patient cases; recommend or escalate cases that do not meet criteria to leadership or the Utilization Review Committee
- Facilitate timely discharges, transfers, and recertifications when level of care is no longer appropriate
- Partner with Medicare, Medicaid, and private insurers to ensure accurate documentation and reimbursement processes
- Respond to denials and authorization changes by reviewing medical records and communicating outcomes to care teams and patients
- Identify trends and utilization concerns; contribute to performance improvement and quality initiatives
- Maintain accurate records, compile reports, and support utilization review program operations
- Provide education to clinical staff on documentation requirements, coverage guidelines, and utilization processes
- Support compliance with all regulatory, accreditation, and organizational standards
- Participate in committee meetings and assist in development of utilization review plans and processes
- Graduate of an accredited Registered Nurse (RN) program; Bachelor's Degree in Nursing preferred
- Active RN license (state-specific requirement applies)
- Minimum of 2 years of acute care nursing experience
- Prior utilization review, case management, or payer review experience preferred
- Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines
- Solid understanding of clinical care practices, diagnoses, treatment modalities, and hospital operations
- Excellent communication skills with the ability to collaborate effectively across teams
- Strong analytical and critical thinking skills to assess clinical appropriateness and compliance
- Proficiency in computer systems and Microsoft Office applications
- Ability to manage multiple priorities in a fast-paced healthcare environment
- Flexibility to adapt to changing schedules, workflows, and departmental needs
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
What Trinity Health employees say
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Benefits
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About Trinity Health
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Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Livonia, MI, US