Job Title: Clinical Review Nurse - Concurrent Review Location:Remote- Nationally but must have ... Disqualifiers: no UM background- must be tech savvy Additional qualities to look for: ICU, Med ...
Job Title: Clinical Review Nurse - Concurrent Review Location:Remote- Nationally but must have ... Disqualifiers: no UM background- must be tech savvy Additional qualities to look for: ICU, Med ...
NY ยท On-site
$80 - $100/hr
Under the general supervision of the Director of Health Services, the Concurrent Review Nurse is responsible for ensuring the delivery of medically necessary, high-quality, and cost-effective care.
NY ยท On-site
$80 - $100/hr
Under the general supervision of the Director of Health Services, the Concurrent Review Nurse is responsible for ensuring the delivery of medically necessary, high-quality, and cost-effective care.
Concurrent Review Nurse
Troy, MI ยท On-site
... concurrent review. Assesses services for Molina Members to ensure optimum outcomes, cost ... Preferably hospital nursing, utilization management, and/or case management. Also has a background ...
Concurrent Review Nurse
Troy, MI ยท On-site
... concurrent review. Assesses services for Molina Members to ensure optimum outcomes, cost ... Preferably hospital nursing, utilization management, and/or case management. Also has a background ...
Clinical - Clinical Review Nurse - Concurrent Review
Hopkinsville, KY ยท On-site
$7.25/hr
Clinical Review Nurse Work Location: Remote- Nationally but must have Compact license if not in KY ... Disqualifiers: no UM background- must be tech savvy * Additional qualities to look for: ICU, Med ...
Clinical - Clinical Review Nurse - Concurrent Review
Hopkinsville, KY ยท On-site
$7.25/hr
Clinical Review Nurse Work Location: Remote- Nationally but must have Compact license if not in KY ... Disqualifiers: no UM background- must be tech savvy * Additional qualities to look for: ICU, Med ...
Concurrent Review Nurse
Bedford, NH ยท On-site
Perform onsite review of emergent/urgent and continued stay requests Qualifications * 2+ years of clinical nursing experience in an acute care. * Current state's RN license. Additional Information ...
Concurrent Review Nurse
Bedford, NH ยท On-site
Perform onsite review of emergent/urgent and continued stay requests Qualifications * 2+ years of clinical nursing experience in an acute care. * Current state's RN license. Additional Information ...
Concurrent Review Nurse
Bedford, NH ยท On-site
Perform onsite review of emergent/urgent and continued stay requests Qualifications * 2+ years of clinical nursing experience in an acute care. * Current state's RN license. Additional Information ...
Concurrent Review Nurse
Bedford, NH ยท On-site
Perform onsite review of emergent/urgent and continued stay requests Qualifications * 2+ years of clinical nursing experience in an acute care. * Current state's RN license. Additional Information ...
Utilization Management Nurse Consultant (RN) - Concurrent Review Remote | Acute Inpatient Utilization Management | RN Opportunity Are you an experienced RN with a background in acute care and ...
Utilization Management Nurse Consultant (RN) - Concurrent Review Remote | Acute Inpatient Utilization Management | RN Opportunity Are you an experienced RN with a background in acute care and ...
Clinical Review Nurse Inpatient Concurrent Review
Saint Louis, MO ยท On-site
$34 - $40/hr
Registered Nurse (RN) with a compact license ... Experience in Utilization Management (UM). * Proficient in concurrent review * Strong computer ...
Clinical Review Nurse Inpatient Concurrent Review
Saint Louis, MO ยท On-site
$34 - $40/hr
Registered Nurse (RN) with a compact license ... Experience in Utilization Management (UM). * Proficient in concurrent review * Strong computer ...
We are aggressively seeking RN Concurrent Review Nurses and RN Case Managers for a Fortune 500 Healthcare organization. Take advantage of flexible hours, a competitive salary, and be a n RN ...
We are aggressively seeking RN Concurrent Review Nurses and RN Case Managers for a Fortune 500 Healthcare organization. Take advantage of flexible hours, a competitive salary, and be a n RN ...
Concurrent Review RN
Waltham, MA ยท On-site
Serve as a subject matter expert for questions or issues for other Concurrent Review Nurses and ... of UM experience in a managed care setting (this is a must) * 2+ years of clinical nursing ...
Concurrent Review RN
Waltham, MA ยท On-site
Serve as a subject matter expert for questions or issues for other Concurrent Review Nurses and ... of UM experience in a managed care setting (this is a must) * 2+ years of clinical nursing ...
Concurrent Review
Nevada, MO ยท On-site
$20.37/hr
Concurrent Review ID: 1454 Location: Nevada, Missouri Department: Quality Status: PRN Shift ... Graduate of an Accredited School of Practical Nursing or Registered Nursing or Graduate of an ...
Concurrent Review
Nevada, MO ยท On-site
$20.37/hr
Concurrent Review ID: 1454 Location: Nevada, Missouri Department: Quality Status: PRN Shift ... Graduate of an Accredited School of Practical Nursing or Registered Nursing or Graduate of an ...
Clinical Review Nurse - Concurrent Review Work Location: Remote Assignment Duration: 9 months Work Arrangement: Remote Work Schedule: Friday-Tues, 2 pm-10 pm CST, 40 hours/week. So, either five 8 ...
Clinical Review Nurse - Concurrent Review Work Location: Remote Assignment Duration: 9 months Work Arrangement: Remote Work Schedule: Friday-Tues, 2 pm-10 pm CST, 40 hours/week. So, either five 8 ...
The primary responsibility of the UM Review Nurse is to conduct prior authorizations and concurrent reviews, using proprietary or online tools for medical necessity and documentation systems that ...
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The primary responsibility of the UM Review Nurse is to conduct prior authorizations and concurrent reviews, using proprietary or online tools for medical necessity and documentation systems that ...
Utilization Management Review Nurse - Temporary
Honolulu, HI ยท On-site
$70K - $85K/yr
The primary responsibility of the UM Review Nurse is to conduct prior authorizations and concurrent reviews, using proprietary or online tools for medical necessity and documentation systems that ...
Utilization Management Review Nurse - Temporary
Honolulu, HI ยท On-site
$70K - $85K/yr
The primary responsibility of the UM Review Nurse is to conduct prior authorizations and concurrent reviews, using proprietary or online tools for medical necessity and documentation systems that ...
The primary responsibility of the UM Review Nurse is to conduct prior authorizations and concurrent reviews, using proprietary or online tools for medical necessity and documentation systems that ...
The primary responsibility of the UM Review Nurse is to conduct prior authorizations and concurrent reviews, using proprietary or online tools for medical necessity and documentation systems that ...
The primary responsibility of the UM Review Nurse is to conduct prior authorizations and concurrent reviews, using proprietary or online tools for medical necessity and documentation systems that ...
The primary responsibility of the UM Review Nurse is to conduct prior authorizations and concurrent reviews, using proprietary or online tools for medical necessity and documentation systems that ...
The primary responsibility of the UM Review Nurse is to conduct prior authorizations and concurrent reviews, using proprietary or online tools for medical necessity and documentation systems that ...
The primary responsibility of the UM Review Nurse is to conduct prior authorizations and concurrent reviews, using proprietary or online tools for medical necessity and documentation systems that ...
Field IP Concurrent Review Nurse
Coral Gables, FL ยท On-site
$73K - $90K/yr
... Nurse or LPN Current, active licensure to practice within the State of Florida Concurrent review experience - 2 year minimum experience Managed Care experience - 1-2 year minimum experience ...
Field IP Concurrent Review Nurse
Coral Gables, FL ยท On-site
$73K - $90K/yr
... Nurse or LPN Current, active licensure to practice within the State of Florida Concurrent review experience - 2 year minimum experience Managed Care experience - 1-2 year minimum experience ...
Our expanding managed care company is seeking RNs for positions in concurrent review and prior authorizations for our Sunrise office. This is a M-F daytime (no holidays/no weekends) fulltime position.
Our expanding managed care company is seeking RNs for positions in concurrent review and prior authorizations for our Sunrise office. This is a M-F daytime (no holidays/no weekends) fulltime position.
This nurse is responsible for performing a variety of pre-admission, concurrent, and retrospective UM related reviews and functions. They must competently and accurately utilize approved screening ...
This nurse is responsible for performing a variety of pre-admission, concurrent, and retrospective UM related reviews and functions. They must competently and accurately utilize approved screening ...
Um Concurrent Review Nurse information
See salary details
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
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Clinical Review Nurse - Concurrent Review
Raleigh, NC โข On-site
Other
This job post hasย expired today.ย Applications are no longer accepted.
Job description
Location:Remote- Nationally but must have Compact license if not in KY (ok with all time zones but must work EST)
Duration : 6 months
Shift : Mon- Fri 8-5pm EST
Job Description:
Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines. Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member.
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Performs concurrent reviews of member for appropriate care and setting to determine overall health and appropriate level of care
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Reviews quality and continuity of care by reviewing acuity level, resource consumption, length of stay, and discharge planning of member
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Works with Medical Affairs and/or Medical Directors as needed to discuss member care being delivered
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Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and guidelines
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Works with healthcare providers to approve medical determinations or provide recommendations based on requested services and concurrent review findings
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Assists with providing education to providers on utilization processes to ensure high quality appropriate care to members
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Provides feedback to leadership on opportunities to improve appropriate level of care and medically necessity based on clinical policies and guidelines
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Reviews member's transfer or discharge plans to ensure a timely discharge between levels of care and facilities
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Collaborates with care management on referral of members as appropriate
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Performs other duties as assigned
Candidate Requirements
Education/Certification
Required: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 2 - 4 years of related experience.
Preferred: BSN
Licensure
Required: LPN
Preferred: RN
Years of experience required: 2-4 years of related experience.
Disqualifiers: no UM background- must be tech savvy
Additional qualities to look for: ICU, Med-surge, Acute Care experience preferred.
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Top 3 must-have hard skills stack-ranked by importance
1
Extensive clinical background.
2
Technologically Savvy
3
Must be able to multi-task.
About SPECTRAFORCE
Sourced by ZipRecruiter
Industry
Recruiting and staffing services
Company size
1,001 - 5,000 Employees
Headquarters location
Raleigh, NC, US
Year founded
2004