Columbus, OH · On-site
Conducts prior authorization reviews to determine financial responsibility Qualifications * 2 years Inpatient background with Hospital Nursing (Med-Surg, ER) * Well versed in Utilization Management ...
Columbus, OH · On-site
Conducts prior authorization reviews to determine financial responsibility Qualifications * 2 years Inpatient background with Hospital Nursing (Med-Surg, ER) * Well versed in Utilization Management ...
Columbus, OH · On-site
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Nurses ...
Columbus, OH · On-site
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Nurses ...
Columbus, OH · On-site
Qualifications Utilization Review in hospital setting . Prior author experience . Inpatient hospital experience . Nurses who are used to doing both production and review work . RN required . Millemen ...
Columbus, OH · On-site
Qualifications Utilization Review in hospital setting . Prior author experience . Inpatient hospital experience . Nurses who are used to doing both production and review work . RN required . Millemen ...
Columbus, OH · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports ... Reviews medically appropriate clinical guidelines and other appropriate criteria with medical ...
Columbus, OH · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports ... Reviews medically appropriate clinical guidelines and other appropriate criteria with medical ...
The Ohio Department of Medicaid (ODM) is seeking a Registered Nurse (RN) to be a part of our Surveillance/Utilization Review Section (SURS). SURS is charged with helping the agency review utilization ...
The Ohio Department of Medicaid (ODM) is seeking a Registered Nurse (RN) to be a part of our Surveillance/Utilization Review Section (SURS). SURS is charged with helping the agency review utilization ...
Columbus, OH · Remote
$29.05 - $67.97/hr
... utilization management and long-term services and supports (LTSS) issues. • Identifies and ... complex claim review including diagnosis-related group (DRG) validation, itemized bill review ...
Columbus, OH · Remote
$29.05 - $67.97/hr
... utilization management and long-term services and supports (LTSS) issues. • Identifies and ... complex claim review including diagnosis-related group (DRG) validation, itemized bill review ...
Columbus, OH · Remote
$29.05 - $67.97/hr
... utilization management and long-term services and supports (LTSS) issues. • Identifies and ... complex claim review including diagnosis-related group (DRG) validation, itemized bill review ...
Columbus, OH · Remote
$29.05 - $67.97/hr
... utilization management and long-term services and supports (LTSS) issues. • Identifies and ... complex claim review including diagnosis-related group (DRG) validation, itemized bill review ...
The Ohio Department of Medicaid (ODM) is seeking a Registered Nurse (RN) to be a part of our Surveillance/Utilization Review Section (SURS). SURS is charged with helping the agency review utilization ...
The Ohio Department of Medicaid (ODM) is seeking a Registered Nurse (RN) to be a part of our Surveillance/Utilization Review Section (SURS). SURS is charged with helping the agency review utilization ...
Columbus, OH · On-site
Job Duties Review medical records to determine appropriateness of admissions, procedures and ... affecting utilization management. PositionRequirements Bachelor's degree required. Active RN ...
Columbus, OH · On-site
Job Duties Review medical records to determine appropriateness of admissions, procedures and ... affecting utilization management. PositionRequirements Bachelor's degree required. Active RN ...
Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ... Utilization review, and/or discharge planning experience desirable. Physical Requirements:
Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ... Utilization review, and/or discharge planning experience desirable. Physical Requirements:
Blacklick, OH · On-site
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. * OASIS experience ...
New
Blacklick, OH · On-site
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. * OASIS experience ...
New
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. * OASIS experience ...
New
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. * OASIS experience ...
New
Utilization review, prior authorization, or managed care experience preferred. * Active OH RN Licensure * Experienced with either Interqual or Milliman Licenses/Certifications: Current RN, required.
Utilization review, prior authorization, or managed care experience preferred. * Active OH RN Licensure * Experienced with either Interqual or Milliman Licenses/Certifications: Current RN, required.
Prior case management, utilization review, and discharge planning experience preferred * Certified Case Manager (CCM) or Board Certification in Nursing Case Management (RN BC) preferred Specific Job ...
Prior case management, utilization review, and discharge planning experience preferred * Certified Case Manager (CCM) or Board Certification in Nursing Case Management (RN BC) preferred Specific Job ...
Columbus, OH · On-site
$85K - $95K/yr
The Registered Nurse (RN) Care Manager plays a vital role in providing exceptional, patient ... Participate actively in team meetings, quality improvement projects, and utilization review ...
Quick apply
Columbus, OH · On-site
$85K - $95K/yr
The Registered Nurse (RN) Care Manager plays a vital role in providing exceptional, patient ... Participate actively in team meetings, quality improvement projects, and utilization review ...
Columbus, OH · On-site
$85K - $95K/yr
The Registered Nurse (RN) Care Manager plays a vital role in providing exceptional, patient ... Participate actively in team meetings, quality improvement projects, and utilization review ...
Quick apply
Columbus, OH · On-site
$85K - $95K/yr
The Registered Nurse (RN) Care Manager plays a vital role in providing exceptional, patient ... Participate actively in team meetings, quality improvement projects, and utilization review ...
Columbus, OH · On-site
$85K - $95K/yr
The Registered Nurse (RN) Care Manager plays a vital role in providing exceptional, patient ... Participate actively in team meetings, quality improvement projects, and utilization review ...
Quick apply
Columbus, OH · On-site
$85K - $95K/yr
The Registered Nurse (RN) Care Manager plays a vital role in providing exceptional, patient ... Participate actively in team meetings, quality improvement projects, and utilization review ...
Columbus, OH · On-site
$85K - $95K/yr
Registered Nurse (RN) Care Manager - Home Health Role Summary: The Registered Nurse (RN) Care ... Participate actively in team meetings, quality improvement projects, and utilization review ...
Quick apply
Columbus, OH · On-site
$85K - $95K/yr
Registered Nurse (RN) Care Manager - Home Health Role Summary: The Registered Nurse (RN) Care ... Participate actively in team meetings, quality improvement projects, and utilization review ...
Columbus, OH · On-site
$85K - $95K/yr
Registered Nurse (RN) Care Manager - Home Health Role Summary: The Registered Nurse (RN) Care ... Participate actively in team meetings, quality improvement projects, and utilization review ...
Quick apply
Columbus, OH · On-site
$85K - $95K/yr
Registered Nurse (RN) Care Manager - Home Health Role Summary: The Registered Nurse (RN) Care ... Participate actively in team meetings, quality improvement projects, and utilization review ...
Gahanna, OH · On-site
$33 - $42.25/hr
... RN/LPN to join our amazing team! Job Duties * Maintain the current MDS status of each resident, in ... Coordinate and attend daily Casemix Meetings, weekly Utilization Review Meetings, and monthly ...
Gahanna, OH · On-site
$33 - $42.25/hr
... RN/LPN to join our amazing team! Job Duties * Maintain the current MDS status of each resident, in ... Coordinate and attend daily Casemix Meetings, weekly Utilization Review Meetings, and monthly ...
$19.99 - $24.03
2% of jobs
$24.03 - $28.08
9% of jobs
$30.84 is the 25th percentile. Wages below this are outliers.
$28.08 - $32.12
21% of jobs
The median wage is $35.39 / hr.
$32.12 - $36.16
23% of jobs
$36.16 - $40.20
13% of jobs
$43.35 is the 75th percentile. Wages above this are outliers.
$40.20 - $44.25
10% of jobs
$44.25 - $48.29
8% of jobs
$48.29 - $52.33
5% of jobs
$52.33 - $56.37
5% of jobs
$56.37 - $60.42
2% of jobs
$60.42 - $64.46
2% of jobs
$19
$39
$64
| Aspect | Utilization Review Rn | Case Manager |
|---|---|---|
| Credentials | RN license, certifications in utilization review | RN license, certifications in case management |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Hospitals, community agencies, insurance companies |
| Primary Focus | Reviewing medical necessity and appropriateness of care | Coordinating patient care and discharge planning |
Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.
Full-time
Posted 25 days ago
Why You Should Work For Us:
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Interested in being considered?
If you are interested in applying to this position, please click the Green I'm Interested Button to email your resume and contact Jeff St Louis 407-478-0332x223.
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Recruiting and staffing services
201 - 500 Employees
Maitland, FL, US
2003
