Registered Nurse Care Coordinator - Fostering Connections Clinic (PFK)
Columbus, OH · On-site
$65 - $90/hr
Columbus, OH · On-site
$65 - $90/hr
Columbus, OH · On-site
$55K - $110K/yr
Columbus, OH · On-site
$65 - $90/hr
Columbus, OH · On-site
$65 - $90/hr
Columbus, OH · On-site
Columbus, OH · On-site
$60 - $85/hr
Columbus, OH · On-site
Newark, OH · On-site
$60 - $80/hr
To become a remote utilization review nurse, you need the same educational qualifications as any registered nurse. To become an RN, you need to complete an associate or bachelor’s degree in nursing and pass the national exam for nursing students. You must also register with the state in which you work. In addition to your educational and professional qualifications, you need to have a strong understanding of the healthcare system, and you typically need several years of experience as a practicing nurse before you can work in utilization review. Because you work from home, you need reliable internet as well.
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Salary range: $69,500 - $101,000
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As a remote utilization management nurse, you work from home to perform a variety of duties and responsibilities, such as corresponding with and interviewing physicians, modifying patient treatment plans, analyzing investigation information, and auditing patient records. As a UM nurse, you may also deal with other clinical tasks, referrals, authorizations, and reviews. You usually work for insurance companies and healthcare providers to help to determine if patients should receive authorization for needed treatments or for those that they already receive. In some cases, you may monitor processes to ensure that hospital patients are getting what they need during their stay.
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Salary range: $69,500 - $101,000
A utilization review nurse determines the best course of treatment for a patient using preapproved policy criteria. Utilization review nurses collect and review patient records, clinical documentation, and billing information to recommend the best use of patient care resources. Their assessments help determine the length of hospital stays, the effectiveness of the care plan, and the necessity of the services administered. Utilization review nurses inform and educate patients about their options based on their insurance benefits and limitations. Utilization review nurses also assess patient care services in clinical appeals for approval or denial.
Salary range: $74,000 - $90,500
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