... 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 RN
Seymour, IN · On-site
Graduate of accredited school of nursing (BSN Preferred) Preferred: Bachelors Degree in Nursing ... Utilization Review and Medical Necessity * Concurrent Review and Length of Stay Management
UTILIZATION REVIEW RN
Seymour, IN · On-site
Graduate of accredited school of nursing (BSN Preferred) Preferred: Bachelors Degree in Nursing ... Utilization Review and Medical Necessity * Concurrent Review and Length of Stay Management
UTILIZATION REVIEW RN
Seymour, IN · On-site
Graduate of accredited school of nursing (BSN Preferred) Preferred: Bachelors Degree in Nursing ... DUTIES 1. Utilization Review and Medical Necessity 2. Concurrent Review and Length of Stay ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
Graduate of accredited school of nursing (BSN Preferred) Preferred: Bachelors Degree in Nursing ... DUTIES 1. Utilization Review and Medical Necessity 2. Concurrent Review and Length of Stay ...
... 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.
... oversees utilization management including, but not limited to: utilization review, case ... Must have Registered Nurse license or Master's Degree. Experience: 5-7 yrs acute inpatient ...
... oversees utilization management including, but not limited to: utilization review, case ... Must have Registered Nurse license or Master's Degree. Experience: 5-7 yrs acute inpatient ...
... setting reviews to ensure compliance with applicable criteria, medical policy, and member ... AS/BS in Nursing or combination of education / experience * 2 years of experience in an acute care ...
... setting reviews to ensure compliance with applicable criteria, medical policy, and member ... AS/BS in Nursing or combination of education / experience * 2 years of experience in an 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 ...
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 ...
The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays ... Graduation from an approved/accredited school of nursing or a Bachelor's degree in social work ...
The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays ... Graduation from an approved/accredited school of nursing or a Bachelor's degree in social work ...
... thorough review of the total resources available to patient pre and post-discharge from ... Bachelor's degree in related field with 3-5 years' experience * LPN or RN experience preferred ...
... thorough review of the total resources available to patient pre and post-discharge from ... Bachelor's degree in related field with 3-5 years' experience * LPN or RN experience preferred ...
... thorough review of the total resources available to patient pre and post-discharge from ... Bachelor's degree in related field with 3-5 years' experience * LPN or RN experience preferred ...
... thorough review of the total resources available to patient pre and post-discharge from ... Bachelor's degree in related field with 3-5 years' experience * LPN or RN experience preferred ...
... thorough review of the total resources available to patient pre and post-discharge from ... Bachelor's degree in related field with 3-5 years' experience * LPN or RN experience preferred ...
... thorough review of the total resources available to patient pre and post-discharge from ... Bachelor's degree in related field with 3-5 years' experience * LPN or RN experience preferred ...
... thorough review of the total resources available to patient pre and post-discharge from ... N experience preferredHoursMonday - Friday (8:30am-5:00pm)This position is on-site at RHI The ...
Quick apply
... thorough review of the total resources available to patient pre and post-discharge from ... N experience preferredHoursMonday - Friday (8:30am-5:00pm)This position is on-site at RHI The ...
Reviewing patient admission clinical information using clinical criteria and guidelines available ... a Nursing program. A valid and current Registered Nurse license in the state of Indiana is which ...
Reviewing patient admission clinical information using clinical criteria and guidelines available ... a Nursing program. A valid and current Registered Nurse license in the state of Indiana is which ...
Reviewing patient admission clinical information using clinical criteria and guidelines available ... a Nursing program. A valid and current Registered Nurse license in the state of Indiana is which ...
Reviewing patient admission clinical information using clinical criteria and guidelines available ... a Nursing program. A valid and current Registered Nurse license in the state of Indiana is which ...
Reviewing patient admission clinical information using clinical criteria and guidelines available ... a Nursing program. A valid and current Registered Nurse license in the state of Indiana is which ...
Reviewing patient admission clinical information using clinical criteria and guidelines available ... a Nursing program. A valid and current Registered Nurse license in the state of Indiana is which ...
Director of Assessment
Indianapolis, IN · On-site
$65K - $90K/yr
Collaborate with Medical Staff, Nursing, Utilization Review, and Business Office teams * Monitor key performance indicators including response times, conversion rates, and census * Drive census ...
Director of Assessment
Indianapolis, IN · On-site
$65K - $90K/yr
Collaborate with Medical Staff, Nursing, Utilization Review, and Business Office teams * Monitor key performance indicators including response times, conversion rates, and census * Drive census ...
Nursing Utilization Review information
What are the key skills and qualifications needed to thrive as a nursing utilization review nurse?
To thrive as a Nursing Utilization Review Nurse, you need strong clinical knowledge, critical thinking, and a current RN license, often complemented by experience in case management or utilization review. Familiarity with healthcare coding systems (ICD-10, CPT), utilization management software, and regulatory compliance tools is typical. Excellent communication, attention to detail, and negotiation skills make someone stand out in this position. These skills ensure accurate assessment of medical necessity, optimize resource use, and support patient care quality within regulatory guidelines.
What is nursing utilization review?
Nursing Utilization Review is a process where nurses evaluate the necessity, efficiency, and appropriateness of healthcare services provided to patients. These nurses review medical records, treatment plans, and patient progress to ensure that care meets established guidelines and is cost-effective. They play a key role in helping healthcare organizations maintain quality care while controlling costs and ensuring regulatory compliance. Utilization review nurses often work for hospitals, insurance companies, or government agencies.
What are some common challenges faced by nurses working in utilization review, and how can they be managed?
Nurses in utilization review often face challenges such as balancing the need for cost-effective care with advocating for patients' clinical needs and navigating complex insurance guidelines. They must critically review medical records while ensuring compliance with evolving regulatory standards. Effective time management and strong communication skills are essential for liaising between healthcare providers, insurance companies, and patients. Ongoing education and collaboration with interdisciplinary teams can help address these challenges and ensure high-quality, patient-centered care.
What is the difference between Nursing Utilization Review vs Nursing Case Management?
| Aspect | Nursing Utilization Review | Nursing Case Management |
|---|---|---|
| Primary Focus | Assessing medical necessity and appropriateness of care for insurance or healthcare providers | Coordinating patient care plans and ensuring optimal health outcomes |
| Work Environment | Insurance companies, healthcare facilities, utilization review organizations | Hospitals, clinics, community health settings |
| Credentials | RN license, often with certifications in utilization review or case management | RN license, case management certification often preferred |
While both roles involve nursing expertise, Nursing Utilization Review primarily focuses on evaluating the necessity of care for insurance purposes, whereas Nursing Case Management emphasizes coordinating patient care to improve health outcomes. Both roles require RN licensure and related certifications, but their daily tasks and work environments differ.
What are popular job titles related to Nursing Utilization Review jobs in Indiana? For Nursing Utilization Review jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Nursing Utilization Review jobs in Indiana look for? The top searched job categories for Nursing Utilization Review jobs in Indiana are:
What cities in Indiana are hiring for Nursing Utilization Review jobs? Cities in Indiana with the most Nursing Utilization Review job openings:
Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 10 days ago
Job description
About UsHealing Body and Mind.
NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. Our hospitals use an interdisciplinary, multi-specialty approach that delivers high-quality, patient-centered care when it's needed most.
With locations in Indiana, Michigan, Texas, and Arizona, we're expanding access to our unique model of care across the United States. Join us and be part of a team dedicated to making a lasting difference in the lives of patients and families every day
OverviewNeuroPsychiatric Hospitals of Indianapolis is looking for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with multidisciplinary teams.
Benefits of joining NPH
- Competitive pay rates
- Medical, Dental, and Vision Insurance
- NPH 401(k) plan with up to 4% Company match
- Employee Assistance Program (EAP) Programs
- Generous PTO and Time Off Policy
- Special tuition offers through Capella University
- Work/life balance with great professional growth opportunities
- Employee Discounts through LifeMart
- Filing documents as needed.
- Initial Precertification with payors.
- Concurrent Clinical review with payors.
- Document in the electronic system daily in real time.
- Admission audit.
- Ensures that CON's/RON's and CMS certifications are completed by provider.
- Consistently demonstrates professionalism with all internal and external customers as evidenced by positive customer and peer Communicates effectively with all staff and patients as evidenced by the establishment and maintenance of productive working relationships.
- Maintains knowledge of current trends and developments in the field by reading appropriate books; journals and other literature and attending related seminars or conferences.
- Maintains a professional approach with Assures protection and privacy of health information as attained through written, electronic or oral disclosures.
- Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
- Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital polices that apply.
- Complies with hospital expectations regarding ethical behavior and standards of conduct.
- Complies with federal and hospital requirements in the areas of protected health information and patient information.
- Reconsiderations, assists with appeals as needed, arrange peer to peer level reviews, and report the outcomes to the VP of Care Management and Team.
- Provides education to nursing staff. ;eadership team, and providers regarding documentation.
- Actively works with the business office regarding resolution of appeals/denials and retrospective reviews.
Education: Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology required. Master's degree preferred.
Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management experience, including discharge planning in a hospital setting required.
Licensure: Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. Basic Life Support (BLS) and Handle with Care (HWC) obtained during orientation, if applicable.
Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.#INDEEDLOW
Employment Type: FULL_TIME