Success in this mission requires a culture of collaboration, excellence, leadership, and respect ... utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing ...
Success in this mission requires a culture of collaboration, excellence, leadership, and respect ... utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing ...
Success in this mission requires a culture of collaboration, excellence, leadership, and respect ... utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing ...
Success in this mission requires a culture of collaboration, excellence, leadership, and respect ... utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing ...
Odyssey House is looking for a Full-Time Utilization Review Specialist. Summary: Odyssey House ... Immediate eligibility to participate in our 403(b)-retirement plan, Employer 100% match up to 5% ...
Odyssey House is looking for a Full-Time Utilization Review Specialist. Summary: Odyssey House ... Immediate eligibility to participate in our 403(b)-retirement plan, Employer 100% match up to 5% ...
Description Odyssey House is looking for a Full-Time Utilization Review Specialist. Summary ... Immediate eligibility to participate in our 403(b)-retirement plan, Employer 100% match up to 5% ...
New
Description Odyssey House is looking for a Full-Time Utilization Review Specialist. Summary ... Immediate eligibility to participate in our 403(b)-retirement plan, Employer 100% match up to 5% ...
New
Odyssey House is looking for a Full-Time Utilization Review Specialist. Summary: Odyssey House ... Immediate eligibility to participate in our 403(b)-retirement plan, Employer 100% match up to 5% ...
New
Quick apply
Odyssey House is looking for a Full-Time Utilization Review Specialist. Summary: Odyssey House ... Immediate eligibility to participate in our 403(b)-retirement plan, Employer 100% match up to 5% ...
New
We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement. THE OPPORTUNITY: We are currently seeking Board-Certified physicians in RADIOLOGY to conduct ...
We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement. THE OPPORTUNITY: We are currently seeking Board-Certified physicians in RADIOLOGY to conduct ...
We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement. THE OPPORTUNITY: We are currently seeking Board-Certified physicians in RADIOLOGY to conduct ...
We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement. THE OPPORTUNITY: We are currently seeking Board-Certified physicians in RADIOLOGY to conduct ...
We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement. THE OPPORTUNITY: We are currently seeking Board-Certified physicians in International Radiology to ...
We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement. THE OPPORTUNITY: We are currently seeking Board-Certified physicians in International Radiology to ...
... in order to prepare authorization for RN or MD review. * Communicates the authorization ... Facilitates Utilization Management processes with Medical Review Officers, UM Nurses, hospitals ...
... in order to prepare authorization for RN or MD review. * Communicates the authorization ... Facilitates Utilization Management processes with Medical Review Officers, UM Nurses, hospitals ...
Live-in Caregiver
Millcreek, UT · On-site
$250 - $275/day
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
Live-in Caregiver
Millcreek, UT · On-site
$250 - $275/day
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
Live-in Caregiver
Salt Lake City, UT · On-site
$250 - $275/day
... completed)CNA School Program - ask for details!PPE provided401(k) with matching - ask for ... Live-in CaregiverThis position not only allows you to earn extra income but also empowers you to ...
Quick apply
Live-in Caregiver
Salt Lake City, UT · On-site
$250 - $275/day
... completed)CNA School Program - ask for details!PPE provided401(k) with matching - ask for ... Live-in CaregiverThis position not only allows you to earn extra income but also empowers you to ...
Experience in Utilization Review Not Required While prior utilization review experience is always valued, many of our most successful team members have come from a variety of backgrounds within the ...
Quick apply
Experience in Utilization Review Not Required While prior utilization review experience is always valued, many of our most successful team members have come from a variety of backgrounds within the ...
Live-in Caregiver
Salt Lake City, UT · On-site
$250 - $275/day
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
Live-in Caregiver
Salt Lake City, UT · On-site
$250 - $275/day
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
Live-in Caregiver
Salt Lake City, UT · On-site
$275/day
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
Live-in Caregiver
Salt Lake City, UT · On-site
$275/day
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
Live-in Caregiver
Salt Lake City, UT · On-site
$250 - $275/day
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
Live-in Caregiver
Salt Lake City, UT · On-site
$250 - $275/day
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
Live-in Caregiver
Salt Lake City, UT · On-site
$250 - $275/day
... completed)CNA School Program - ask for details!PPE provided401(k) with matching - ask for ... Live-in CaregiverThis position not only allows you to earn extra income but also empowers you to ...
Quick apply
Live-in Caregiver
Salt Lake City, UT · On-site
$250 - $275/day
... completed)CNA School Program - ask for details!PPE provided401(k) with matching - ask for ... Live-in CaregiverThis position not only allows you to earn extra income but also empowers you to ...
Live-in Caregiver
Salt Lake City, UT · On-site
$250 - $275/day
... completed)CNA School Program - ask for details!PPE provided401(k) with matching - ask for ... Live-in CaregiverThis position not only allows you to earn extra income but also empowers you to ...
Quick apply
Live-in Caregiver
Salt Lake City, UT · On-site
$250 - $275/day
... completed)CNA School Program - ask for details!PPE provided401(k) with matching - ask for ... Live-in CaregiverThis position not only allows you to earn extra income but also empowers you to ...
Live-in Caregiver
Salt Lake City, UT · On-site
$250 - $275/day
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
Live-in Caregiver
Salt Lake City, UT · On-site
$250 - $275/day
These live-in shifts run 1-4 days at a time, allowing you to stay with one client in their home ... Generous bonus after 60 days (20+ hours/week and required documents completed) * CNA School Program ...
Live In Cigna Utilization Review Nurse information
What are the most commonly searched types of Cigna Utilization Review Nurse jobs in Utah?
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For Live In Cigna Utilization Review Nurse jobs in Utah, the most frequently searched job titles are:
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Utilization Review Nurse
Salt Lake City, UT • On-site
University of Utah •
Colleges, Universities, and Professional Schools • 10K+ employees10,000+ employees
7.2
Based on 159 frontline employees who took The Breakroom Quiz
387th of 627 rated colleges and universities
People enjoy working here
Good employer
Recommended by students
Respectful managers
Uninterrupted breaks
Other
Re-posted 8 days ago
Job description
Overview
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
Required
Qualifications (Preferred)
Preferred
Employee must be able to meet the following requirements with or without an accommodation.
Physical Requirements
Color Determination, Listening, Manual Dexterity, Sitting, Speaking, Standing, Walking
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.
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
About University of Utah
Sourced by ZipRecruiter
The University of Utah is the state’s flagship institution of higher education, with 18 schools and colleges, more than 100 undergraduate majors and graduate programs, and an enrollment of more than 38,000 students. It is a member of the Association of American Universities—an invitation-only, prestigious group of 71 leading research institutions. The U is advancing a new national model for higher education that delivers societal impact through education, research, health care, and community service, while making social, economic, and cultural contributions that improve lives across Utah and around the world.
Industry
Colleges, universities, and professional schools
Company size
10,000+ Employees
Headquarters location
Salt Lake City, UT, US
Website
What University Of Utah employees say
Pay
Benefits
Hours and flexibility
Workplace
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