Springfield, IL · On-site
$32.95 - $52.73/hr
Minimum of 3- 5 years of recent acute care and/or home health nursing or case management experience required. Previous utilization review experience strongly preferred. Other Knowledge/Skills ...
Springfield, IL · On-site
$32.95 - $52.73/hr
Minimum of 3- 5 years of recent acute care and/or home health nursing or case management experience required. Previous utilization review experience strongly preferred. Other Knowledge/Skills ...
The Utilization Review Director oversees utilization management including, but not limited to ... Registered Nurse License required * Social Work, Marriage and Family, Mental Health Counseling (i.e.
The Utilization Review Director oversees utilization management including, but not limited to ... Registered Nurse License required * Social Work, Marriage and Family, Mental Health Counseling (i.e.
Springfield, IL · On-site
$37.55 - $56.33/hr
The Utilization Review Director o versees utilization management including, but not limited to ... Registered Nurse License required * Social Work, Marriage and Family, Mental Health Counseling (i.e.
Springfield, IL · On-site
$37.55 - $56.33/hr
The Utilization Review Director o versees utilization management including, but not limited to ... Registered Nurse License required * Social Work, Marriage and Family, Mental Health Counseling (i.e.
Utilization Management Physician Reviewer Location: Fully Remote Salary: $230k per year Role ... Review service requests and document the rationale for the decision in easy to understand language ...
Utilization Management Physician Reviewer Location: Fully Remote Salary: $230k per year Role ... Review service requests and document the rationale for the decision in easy to understand language ...
Springfield, IL · On-site
... care utilization. * Prescribe medications and treatments, including controlled substances, as ... Communicate findings, treatment plans, diagnostics, and medication reviews with IDG/IDT. * Provide ...
Posted today
Springfield, IL · On-site
... care utilization. * Prescribe medications and treatments, including controlled substances, as ... Communicate findings, treatment plans, diagnostics, and medication reviews with IDG/IDT. * Provide ...
Posted today
... care utilization. * Prescribe medications and treatments, including controlled substances, as ... Communicate findings, treatment plans, diagnostics, and medication reviews with IDG/IDT. * Provide ...
... care utilization. * Prescribe medications and treatments, including controlled substances, as ... Communicate findings, treatment plans, diagnostics, and medication reviews with IDG/IDT. * Provide ...
... care utilization. * Prescribe medications and treatments, including controlled substances, as ... Communicate findings, treatment plans, diagnostics, and medication reviews with IDG/IDT. * Provide ...
New
... care utilization. * Prescribe medications and treatments, including controlled substances, as ... Communicate findings, treatment plans, diagnostics, and medication reviews with IDG/IDT. * Provide ...
New
... review. Bachelor's degree in counseling, nursing or a closely related field. Master's degree preferred. * Knowledge and familiarity with the utilization management process in order to maximize ...
New
... review. Bachelor's degree in counseling, nursing or a closely related field. Master's degree preferred. * Knowledge and familiarity with the utilization management process in order to maximize ...
New
Springfield, IL · On-site
$51K - $82K/yr
... review. Bachelor's degree in counseling, nursing or a closely related field. Master's degree preferred. * Knowledge and familiarity with the utilization management process in order to maximize ...
Springfield, IL · On-site
$51K - $82K/yr
... review. Bachelor's degree in counseling, nursing or a closely related field. Master's degree preferred. * Knowledge and familiarity with the utilization management process in order to maximize ...
Springfield, IL · On-site
$51K - $82K/yr
... review. Bachelor's degree in counseling, nursing or a closely related field. Master's degree preferred. * Knowledge and familiarity with the utilization management process in order to maximize ...
New
Springfield, IL · On-site
$51K - $82K/yr
... review. Bachelor's degree in counseling, nursing or a closely related field. Master's degree preferred. * Knowledge and familiarity with the utilization management process in order to maximize ...
New
... review of the EDRP application. Former EDRP participants ineligible to apply. Qualifications ... Advanced Practice Nurse (Nurse Practitioner) Basic Requirements * Education: A post-master ...
New
... review of the EDRP application. Former EDRP participants ineligible to apply. Qualifications ... Advanced Practice Nurse (Nurse Practitioner) Basic Requirements * Education: A post-master ...
New
Nurse Practitioner (NP) or Physician Assistant (PA) - Veteran Disability Assessments We are seeking ... S. Veterans. · Review and analyze electronic medical records via a secure web portal. · ...
Quick apply
Nurse Practitioner (NP) or Physician Assistant (PA) - Veteran Disability Assessments We are seeking ... S. Veterans. · Review and analyze electronic medical records via a secure web portal. · ...
$120K - $148K/yr
What we offer Nurse Practitioners: * The ability to work closely with adults and the child ... reviewed or responded to. To apply for a position, please use our official careers page.
Quick apply
$120K - $148K/yr
What we offer Nurse Practitioners: * The ability to work closely with adults and the child ... reviewed or responded to. To apply for a position, please use our official careers page.
Springfield, IL · On-site
$120K - $148K/yr
What we offer Nurse Practitioners: * The ability to work closely with adults and the child ... reviewed or responded to. To apply for a position, please use our official careers page.
Springfield, IL · On-site
$120K - $148K/yr
What we offer Nurse Practitioners: * The ability to work closely with adults and the child ... reviewed or responded to. To apply for a position, please use our official careers page.
$120K - $148K/yr
What we offer Nurse Practitioners: * The ability to work closely with adults and the child ... not be reviewed or responded to. To apply for a position, please use our official careers page ...
$120K - $148K/yr
What we offer Nurse Practitioners: * The ability to work closely with adults and the child ... not be reviewed or responded to. To apply for a position, please use our official careers page ...
Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...
Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...
Springfield, IL · On-site
Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...
Quick apply
Springfield, IL · On-site
Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...
Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...
Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...
Springfield, IL · On-site
Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...
Springfield, IL · On-site
Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...
Springfield, IL · On-site
Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...
Springfield, IL · On-site
Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...
$21.20 - $25.49
2% of jobs
$25.49 - $29.78
9% of jobs
$32.71 is the 25th percentile. Wages below this are outliers.
$29.78 - $34.07
21% of jobs
The median wage is $37.54 / hr.
$34.07 - $38.36
23% of jobs
$38.36 - $42.65
13% of jobs
$45.98 is the 75th percentile. Wages above this are outliers.
$42.65 - $46.93
10% of jobs
$46.93 - $51.22
8% of jobs
$51.22 - $55.51
5% of jobs
$55.51 - $59.80
5% of jobs
$59.80 - $64.09
2% of jobs
$64.09 - $68.38
2% of jobs
$21
$41
$68
| Aspect | Utilization Review Np | Utilization Review Nurse |
|---|---|---|
| Credentials | Master's degree in Nursing, Nurse Practitioner certification, state licensure | Registered Nurse (RN) license, possibly with certification in utilization review |
| Work Environment | Healthcare facilities, insurance companies, utilization review organizations | Hospitals, insurance companies, outpatient clinics |
| Job Responsibilities | Assess medical necessity, authorize treatments, make clinical decisions, often with greater autonomy | Review medical records, support authorization processes, follow established guidelines |
Utilization Review NPs typically have advanced clinical training and greater decision-making authority compared to Utilization Review Nurses. Both roles focus on evaluating medical necessity, but NPs often perform more complex assessments and can make independent recommendations, whereas nurses support the review process under supervision or guidelines.
$32.95 - $52.73/hr
Full-time
Re-posted 4 days ago
6.9
Based on 175 frontline employees who took The Breakroom Quiz
453rd of 887 rated healthcare providers
Shift: 12pm - 12am
Performs clinical review of patient records to evaluate the utilization of acute care services. Communicates to third party payors to support the medical necessity of the hospital admission for services reimbursement. Ensures the patient care team is aware of general length of stay requirements for all patients. Facilitates physician documentation through concurrent interaction with physicians to support reimbursement and clinical severity is captured for the service rendered to patients receiving hospital care. Provides clinical knowledge and data collection for quality improvement initiatives. Optimizes reimbursement for acute care services.
This is NOT a remote position.
QualificationsEducation:
Associates Degree in Nursing. Bachelor's Degree in Nursing preferred.
Evidence of continuing professional development
Licensure/Certification/Registry:
Current RN licensure in the State of Illinois required
Experience:
Minimum of 3- 5 years of recent acute care and/or home health nursing or case management experience required. Previous utilization review experience strongly preferred.
Other Knowledge/Skills/Abilities:
Understanding of healthcare reimbursement mechanisms preferred.
Strong oral and written communication skills.
Demonstrated adaptability to changes in health care environment with proactive problem solving attitudes
Understanding of the principles of performance improvement, team collaboration, and conflict resolution
Employment Type: FULL_TIMEGet the full story on Breakroom
Sourced by ZipRecruiter
Health care and social assistance and hospitals
5,001 - 10,000 Employees
Springfield, IL, US
