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Internship Rn Utilization Review Nurse Jobs in Nebraska

P3 Health Partners

RN Care Manager

Lincoln, NE · On-site

$85K - $105K/yr

We are looking for a RN Care Manager . If you are passionate about your work; eager to have fun ... The Care Manager may be responsible for activities overlapping with utilization review and quality ...

Bryan Health

Care Transitions RN

Lincoln, NE

The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial and ... Performs utilization review activities, including preadmission screening, insurance verification ...

Bryan Health

Care Transitions RN

Lincoln, NE

The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial and ... Performs utilization review activities, including preadmission screening, insurance verification ...

P3 Health Partners

RN Care Manager

Lincoln, NE · On-site

$85K - $105K/yr

We are looking for a RN Care Manager . If you are passionate about your work; eager to have fun ... The Care Manager may be responsible for activities overlapping with utilization review and quality ...

Bryan Health

Care Transitions RN

Lincoln, NE · On-site

The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial and ... Performs utilization review activities, including preadmission screening, insurance verification ...

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Internship Rn Utilization Review Nurse information

What is an Internship RN Utilization Review Nurse?

An Internship RN Utilization Review Nurse is a registered nurse who is in a training or internship phase to learn how to evaluate the necessity, appropriateness, and efficiency of healthcare services provided to patients. This role involves reviewing patient records, coordinating with healthcare providers, and ensuring that treatments meet established guidelines and insurance requirements. The internship provides hands-on experience in the field of utilization review, helping nurses transition from direct patient care to a more administrative or case management-focused role. It is an entry-level opportunity for RNs interested in healthcare quality and cost management.

What types of tasks and learning experiences can I expect as an Internship RN Utilization Review Nurse?

As an Internship RN Utilization Review Nurse, you will typically assist experienced utilization review nurses in evaluating patient records, verifying the necessity of medical procedures, and ensuring compliance with insurance or regulatory guidelines. You'll gain exposure to interdisciplinary communication by collaborating with physicians, case managers, and insurance representatives. This role provides valuable insight into how clinical decisions impact both patient outcomes and healthcare costs, helping you develop analytical and communication skills essential for future advancement. Expect to participate in chart reviews, learn about medical necessity criteria, and attend case discussions as part of your hands-on learning.

What are the key skills and qualifications needed to thrive as an Internship RN Utilization Review Nurse, and why are they important?

To thrive as an Internship RN Utilization Review Nurse, you need a solid foundation in nursing principles, clinical assessment, and case management, typically supported by an RN license and current enrollment in a nursing program. Familiarity with medical coding systems (like ICD-10 or CPT), electronic health records (EHRs), and utilization review software is often required. Strong analytical thinking, communication skills, and attention to detail set candidates apart in this role. These competencies are crucial for ensuring appropriate patient care, regulatory compliance, and effective resource utilization within healthcare organizations.

What is the difference between Internship Rn Utilization Review Nurse vs Utilization Review Nurse?

AspectInternship Rn Utilization Review NurseUtilization Review Nurse
CredentialsRN license, internship or training programRN license, certification in utilization review often preferred
Work EnvironmentTraining setting, supervised, learning-focusedClinical or office setting, independent review tasks
Job ResponsibilitiesAssisting in review processes, gaining experiencePerforming utilization reviews, making coverage decisions

Internship Rn Utilization Review Nurse is a training role for nursing students or new graduates gaining experience, while Utilization Review Nurse is a full-time professional responsible for evaluating medical necessity and coverage. The internship role focuses on learning, whereas the utilization review nurse performs independent assessments in healthcare settings.

What are the most commonly searched types of Rn Utilization Review Nurse jobs in Nebraska?

The most popular types of Rn Utilization Review Nurse jobs in Nebraska are:

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For Internship Rn Utilization Review Nurse jobs in Nebraska, the most frequently searched job titles are:

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Internship Rn Utilization Review Nurse jobs near you

RN Care Manager

P3 Health Partners

Lincoln, NE • On-site

$85K - $105K/yr

Other

Posted 26 days ago

P3 Health Partners rating

6.6

Company rating: 6.6 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

People. Passion. Purpose.
At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.
We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.
We are looking for a RN Care Manager. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization in Las Vegas, Nevada, then you should consider joining our team.
Work Location & Schedule
This role offers a hybrid work arrangement. Candidates will follow our hybrid schedule, working in office three days per week.
Overall Purpose:
This position is responsible for ensuring that assigned patient population(s) receive continuous, comprehensive and coordinated care throughout the continuum. Through case finding, data and other tools, high risk patients will be identified and guided to enhance the achievement of the Quadruple Aim: improved outcomes, improved experience of care for patients and providers and lower healthcare costs.
The Care Manager will utilize the nursing process of assessment, planning, implementation and evaluation as well as clinical judgment. Interventions with patients and / or stakeholders may be face to face or telephonic. The Care Manager may be responsible for activities overlapping with utilization review and quality management programs.
Essential Job Functions:
  • Promote the mission, vision and values of P3 Health Partners
  • Responsible for comprehensive patient assessments through medical records, clinician and patient interviews, telephonic and / or face to face
  • Develops, implements and evaluates patient care plans
  • Collaborates with Medical Management teams regarding care plans and patient’s progress
  • Identifies care needs and barriers to care. Develops plans to improve
  • Prepares documentation, as per timelines and policy
  • Coordinates care for assigned high risk patient population
  • Works with patients, families and care-givers to promote self- management and meet care plan goals
  • Builds relationships with PCPs, internal and external customers
  • Addresses gaps in care
Experience:
  • Strong clinical judgment and problem -solving skills required
  • Experience in Care Management preferred
  • Experience with Special Needs Programs [SNPs] preferred
  • Managed care experience preferred
  • Utilization review and discharge planning experience preferred
  • Excellent communication skills with patients, providers, internal and external customers required
  • Must have excellent computer skills
  • Must have excellent organizational skills and ability to work independently, with minimal supervision
Licensure / Certification:
  • Ability to obtain and maintain current registration to practice as a Registered Nurse in Nevada, Arizona, Oregon, and California
  • Certification in case management or ability to obtain within two years of employment
  • CPR certified or ability to obtain within 60 days of employment

Education:
Graduate from an Accredited School of Nursing or other applicable clinical role. Bachelor’s degree in Nursing preferred.
Pay range: $85,000-105,000 depending on experience
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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