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Hourly Weekend Utilization Review Jobs in Alabama

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Hourly Weekend Utilization Review information

What is the difference between Hourly Weekend Utilization Review vs Medical Billing Specialist?

AspectHourly Weekend Utilization ReviewMedical Billing Specialist
CredentialsTypically requires healthcare-related certifications, such as RHIT or RHIARequires coding certifications like CPC or CCS
Work EnvironmentHealthcare facilities, insurance companies, or utilization review organizations, often during weekendsMedical offices, billing companies, or hospitals, primarily weekdays
Job FocusAssessing patient care and resource utilization during weekendsProcessing insurance claims, coding, and billing

Hourly Weekend Utilization Review involves evaluating patient care and resource use during weekends, often requiring healthcare certifications. In contrast, Medical Billing Specialists focus on coding and billing processes, mainly during weekdays. Both roles are essential in healthcare operations but differ in focus, credentials, and work hours.

What are the most commonly searched types of Weekend Utilization Review jobs in Alabama? The most popular types of Weekend Utilization Review jobs in Alabama are:
Hourly Weekend Utilization Review jobs near you

Travel RN - Case Management/Utilization Review - Case Management

American Traveler

Madison, AL • On-site

Other

Re-posted 7 days ago

Job description

American Traveler is hiring an experienced RN Case Manager with a CA RN license and 5+ years of inpatient acute case management experience for a hospital-based role requiring discharge planning expertise.
Job Details
• Work in the acute hospital Case Management department,
• 13-week assignment on day shift, 5x8 hours (8:00 AM - 4:30 PM),
• Every other weekend required,
• Patient ratio of 1:10,
• Preferred experience with Epic charting system,
• May be assigned to Emergency Department, ICU, Medical-Surgical, or SDU/PCU/IMC/Observation units,
• Preferred experience in teaching hospital, community hospital, and LTAC settings,
Job Requirements
• Active CA RN license required,
• Current BLS certification required (AHA or ARC),
• Minimum 5 years of RN Case Management experience required,
• Inpatient Acute Case Management hospital experience required,
• Discharge planning experience required with specific facility experience noted,
• Prior travel nursing experience required,
• Preferred experience with InterQual Criteria and Milliman Guidelines,
• Preferred experience with utilization review including admission criteria, appeals and denials, and concurrent review,
• Preferred previous charge nurse experience,
• Preferred knowledge of CMS regulations and DRG (Diagnosis Related Groups),
• Two references from supervisors obtained within the past year required for consideration,
Additional Information
• Coordinate care and transitions planning throughout the acute care patient experience,
• Collaborate with physicians, utilization managers, medical social workers, and bedside RNs to ensure timely progression of patients to appropriate levels of care,
• Conduct patient assessments to determine readmission risk and screen for ancillary supportive services including Palliative Care,
• Review medical records to ensure patients meet level of care requirements and monitor length of stay,
• Screen 30-day readmissions and create effective transition plans in collaboration with interdisciplinary teams,
• Identify high utilizers and complex psychosocial cases, making appropriate referrals to community resources,
• Participate in patient rounds and interdisciplinary team meetings,
• Must reside within a 50-mile radius to qualify for local candidate rate,
• Holiday coverage required for one of the following: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, or Christmas Day,
• Maximum RTO of 7 days per contract with only 1 holiday request approved per contract,
• Returning employees must have a separation period of at least 1 year to be eligible to return as a traveler,
• Compliance documentation, including lab work, must be completed within 3-5 days of contract signing,
• First-time travelers are not being considered for this position

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