Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Case Manager RN Weekends
Des Moines, IA · On-site
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Case Manager RN Weekends
Des Moines, IA · On-site
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Utilization Review certification within 12 months of hire preferred. * Completion of Mandatory Reporter abuse training within three (3) months of hire. Work Environment & Physical Requirements
Regional Reimbursement Nurse Consultant
West Des Moines, IA · Remote
$90K - $110K/yr
Quarterly travel to assigned facilities will be required for on-site audits, training, clinical reimbursement review, and team support. This role is ideal for a highly organized MDS professional with ...
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Regional Reimbursement Nurse Consultant
West Des Moines, IA · Remote
$90K - $110K/yr
Quarterly travel to assigned facilities will be required for on-site audits, training, clinical reimbursement review, and team support. This role is ideal for a highly organized MDS professional with ...
Case Manager RN
Des Moines, IA · On-site
Knowledge of CMS regulations, insurance eligibility, and utilization review processes preferred * Mandatory Reporter Abuse Training required within 3 months of hire Why MercyOne? At MercyOne, you'll ...
Case Manager RN
Des Moines, IA · On-site
Knowledge of CMS regulations, insurance eligibility, and utilization review processes preferred * Mandatory Reporter Abuse Training required within 3 months of hire Why MercyOne? At MercyOne, you'll ...
Knowledge of CMS regulations, insurance eligibility, and utilization review processes preferred * Mandatory Reporter Abuse Training required within 3 months of hire Why MercyOne? At MercyOne, you'll ...
Knowledge of CMS regulations, insurance eligibility, and utilization review processes preferred * Mandatory Reporter Abuse Training required within 3 months of hire Why MercyOne? At MercyOne, you'll ...
Case Manager RN
Des Moines, IA · On-site
Knowledge of CMS regulations, insurance eligibility, and utilization review processes preferred * Mandatory Reporter Abuse Training required within 3 months of hire Why MercyOne? At MercyOne, you'll ...
Case Manager RN
Des Moines, IA · On-site
Knowledge of CMS regulations, insurance eligibility, and utilization review processes preferred * Mandatory Reporter Abuse Training required within 3 months of hire Why MercyOne? At MercyOne, you'll ...
Physician Reviewer-Radiology (Full-Time)
Des Moines, IA · On-site
$95 - $96/hr
Medical
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... Participates in on-going training per inter-rater reliability process. Qualifications: * MD/DO/MBBS
Physician Reviewer-Radiology (Full-Time)
Des Moines, IA · On-site
$95 - $96/hr
Medical
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... Participates in on-going training per inter-rater reliability process. Qualifications: * MD/DO/MBBS
Physician Reviewer-Radiology (Part Time)
Des Moines, IA · On-site
$95 - $100/hr
Medical
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... Participates in on-going training per inter-rater reliability process. Qualifications: * MD/DO/MBBS
Physician Reviewer-Radiology (Part Time)
Des Moines, IA · On-site
$95 - $100/hr
Medical
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... Participates in on-going training per inter-rater reliability process. Qualifications: * MD/DO/MBBS
Rheumatologist-Physician Reviewer-Radiology (Full-Time)
Des Moines, IA · On-site
$95 - $109/hr
Medical
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... Participates in on-going training per inter-rater reliability process. Qualifications: * MD/DO/MBBS
Rheumatologist-Physician Reviewer-Radiology (Full-Time)
Des Moines, IA · On-site
$95 - $109/hr
Medical
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... Participates in on-going training per inter-rater reliability process. Qualifications: * MD/DO/MBBS
Otolaryngologist-Physician Reviewer-Radiology (Full-Time)
Des Moines, IA · On-site
$95 - $109/hr
Medical
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... Participates in on-going training per inter-rater reliability process. Qualifications: * MD/DO/MBBS
Otolaryngologist-Physician Reviewer-Radiology (Full-Time)
Des Moines, IA · On-site
$95 - $109/hr
Medical
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... Participates in on-going training per inter-rater reliability process. Qualifications: * MD/DO/MBBS
Endocrinology-Physician Reviewer-Radiology (Full-Time)
Des Moines, IA · On-site
$95 - $109/hr
Medical
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... Participates in on-going training per inter-rater reliability process. Qualifications: * MD/DO/MBBS
Endocrinology-Physician Reviewer-Radiology (Full-Time)
Des Moines, IA · On-site
$95 - $109/hr
Medical
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... Participates in on-going training per inter-rater reliability process. Qualifications: * MD/DO/MBBS
Nursing Services Director
Fort Dodge, IA · On-site
$81K - $124K/yr
Participate in weekly Medical Admissions calls and Mental Health Utilization Review meetings to ... user training. Public Health and Emergency Preparedness A. Lead nursing components of outbreak ...
Nursing Services Director
Fort Dodge, IA · On-site
$81K - $124K/yr
Participate in weekly Medical Admissions calls and Mental Health Utilization Review meetings to ... user training. Public Health and Emergency Preparedness A. Lead nursing components of outbreak ...
Family Medicine-Physician Reviewer-Radiology (Full-Time or Part-time)
Des Moines, IA · On-site
$95 - $96/hr
Medical
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... Participates in on-going training per inter-rater reliability process. Qualifications: * MD/DO/MBBS
Family Medicine-Physician Reviewer-Radiology (Full-Time or Part-time)
Des Moines, IA · On-site
$95 - $96/hr
Medical
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... Participates in on-going training per inter-rater reliability process. Qualifications: * MD/DO/MBBS
Free Utilization Review Training information
What is free utilization review training?
Free utilization review training refers to educational programs or courses that teach individuals the fundamentals of utilization review without requiring payment. Utilization review is a process used in healthcare to assess the necessity, efficiency, and appropriateness of medical services, procedures, or admissions. These free training options are often available online and can help nurses, case managers, or other healthcare professionals gain the skills needed to pursue roles in utilization management. Training typically covers topics such as clinical guidelines, insurance protocols, and regulatory compliance. Completing such training can enhance career opportunities in healthcare case management and insurance settings.
What are the key skills and qualifications needed to thrive as a utilization review nurse, and why are they important?
To thrive as a Utilization Review Nurse, you need a current RN license, strong clinical assessment skills, and knowledge of insurance and healthcare regulations. Familiarity with utilization management software, electronic health records (EHRs), and possibly certifications like Certified Utilization Review Nurse (CURN) are typically expected. Excellent communication, analytical thinking, and attention to detail are standout soft skills in this position. These abilities are crucial for ensuring appropriate patient care, compliance, and cost-effective healthcare delivery.
What are some common challenges faced by professionals during utilization review training, and how can they be overcome?
During utilization review training, professionals often encounter challenges such as adapting to complex healthcare regulations, learning to interpret medical records efficiently, and effectively applying clinical guidelines to decision-making. Overcoming these challenges requires strong attention to detail, ongoing engagement with training modules, and seeking mentorship from experienced utilization review nurses or case managers. Actively participating in case discussions and staying updated with industry standards can also help trainees build confidence and competence for a successful career in utilization review.
What is the difference between Free Utilization Review Training vs Utilization Review Nurse?
| Aspect | Free Utilization Review Training | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically no formal credentials required; focus on training programs | Registered Nurse (RN) license required, with possible certifications like CCM or UR-specific credentials |
| Work Environment | Training sessions, online courses, workshops | Hospitals, insurance companies, healthcare facilities |
| Employer & Industry Usage | Used for skill development and certification prep | Performing reviews, making coverage decisions, ensuring appropriate care |
Free Utilization Review Training provides foundational knowledge and skills for those interested in entering or advancing in utilization review roles. In contrast, a Utilization Review Nurse is a licensed healthcare professional actively performing review duties in clinical settings. The training is often a prerequisite or supplement to the nurse's practical work, which requires licensure and clinical experience.
How to become a free utilization review training?
To pursue free utilization review training, individuals can seek online courses, webinars, or workshops offered by healthcare organizations or professional associations. Gaining knowledge of medical terminology, insurance processes, and review protocols is essential, and some programs may require prior healthcare experience or certification in related fields.
What are popular job titles related to Free Utilization Review Training jobs in Iowa?
For Free Utilization Review Training jobs in Iowa, the most frequently searched job titles are:
- Evening Utilization Review Nurse
- Remote Utilization Review Rn
- Evening Optum Health Utilization Review
- Per Diem Utilization Review Nurse
- Freelance Utilization Review Nurse
- Therapist Utilization Review Remote
- Home Based Utilization Review Nurse
- Remote Utilization Review Nurse
- Utilization Review Physician
- Remote Utilization Management Nurse
What job categories do people searching Free Utilization Review Training jobs in Iowa look for?
The top searched job categories for Free Utilization Review Training jobs in Iowa are:
What cities in Iowa are hiring for Free Utilization Review Training jobs?
Cities in Iowa with the most Free Utilization Review Training job openings:
Trinity Health rating
6.6
Based on 354 frontline employees who took The Breakroom Quiz
569th of 889 rated healthcare providers
Job description
Employment Type:Full timeShift:Weekend ShiftDescription:RN Case Manager (Onsite)
Shift:
Weekends: Saturday and Sunday 7am - 7:30 PM
General Summary:
Responsible for the review of inpatient and outpatient admission records for appropriate admission status at Mercy Medical Center and Mercy West Lakes. Works in collaboration with the attending physician and the Case Management staff utilizing admission criteria guidelines-and second level physician review process when appropriate. Interacts with insurance providers to obtain authorization and continued stay approval for admission. Collaborates with the Verification department, Revenue cycle and Medical Eligibility to facilitate the establishment of the correct payer source for patient stay and the documentation of the interactions in the STAR admitting system
Key ResponsibilitiesPerform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements.
Apply Milliman Care Guidelines and payer-specific criteria to determine appropriate patient status.
Collaborate with attending physicians to clarify admission status and initiate second-level physician reviews as needed.
Communicate status changes promptly to Case Management, Admitting, and other relevant departments.
Provide patient/family education and issue Notices of Status Change when required.
Accurately document utilization review activities, status determinations, authorizations, denials, and communications in the medical record and STAR system.
Submit timely clinical information to payers to prevent technical denials and support authorization and continued stay.
Review and route denial notifications for appeal consideration; collaborate with post-denials, RAC, and appeal teams.
Monitor insurance coverage and communicate updates to verification and financial teams.
Participate in peer-to-peer reviews and advocate for appropriate admission status and continued stay.
Current Iowa RN license.
Minimum of five (5) years of clinical nursing experience.
BSN or healthcare-related degree preferred.
Knowledge of insurance eligibility, CMS rules, and utilization review processes across the continuum of care.
Strong clinical judgment, communication, and independent decision-making skills.
Utilization Review certification within 12 months of hire preferred.
Completion of Mandatory Reporter abuse training within three (3) months of hire.
Primarily office-based with computer, phone, and documentation tasks.
Light physical activity with occasional lifting; use of assistive devices and additional personnel as required.
Visual acuity sufficient to review medical records and electronic systems.
Ability to work collaboratively in a fast-paced, high-stress healthcare environment while maintaining professionalism and courtesy.
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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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