Talent.com
Ohio Licensed Utilization Management RN
Ohio Licensed Utilization Management RNVirtualVocations • Hamilton, New Jersey, United States
Ohio Licensed Utilization Management RN

Ohio Licensed Utilization Management RN

VirtualVocations • Hamilton, New Jersey, United States
4 days ago
Job type
  • Full-time
Job description

A company is looking for a Utilization Management RN Reviewer.

Key Responsibilities

Conduct admission, concurrent, and retrospective reviews of patient charts and clinical systems

Collaborate with physicians and enterprise advisors to ensure compliance with regulatory guidelines

Document and report on utilization management processes and participate in special projects as needed

Required Qualifications

Graduate from an accredited school of professional Nursing

Current state licensure as a Registered Nurse (RN)

Basic Life Support (BLS) Certification through the American Heart Association (AHA)

Three years of full-time clinical RN experience

Knowledge of medical terminology, anatomy, physiology, and basic disease processes

Create a job alert for this search

Utilization Management Rn • Hamilton, New Jersey, United States

Related jobs
Ohio Licensed Care Management Manager

Ohio Licensed Care Management Manager

VirtualVocations • Hamilton, New Jersey, United States
Full-time
A company is looking for a Manager, Community-Based Care Management.Key Responsibilities Oversee a team of clinical and nonclinical staff to meet service level and production expectations Facili...Show more
Last updated: 4 days ago • Promoted
Wellness Manager (RN)

Wellness Manager (RN)

Ann's Choice by Erickson Senior Living • Warminster, PA, United States
Full-time
Ann's Choice by Erickson Senior Living.Join our team as the Wellness Manager oversees the care performance of the teams within Assisted Living and Memory Care and is committed to providing clinical...Show more
Last updated: 23 days ago • Promoted
California Licensed Utilization Management Nurse

California Licensed Utilization Management Nurse

VirtualVocations • Hamilton, New Jersey, United States
Full-time
A company is looking for a Utilization Management Nurse - LVN (Work from Home).Key Responsibilities Perform medical necessity reviews for assigned members Collaborate with the Medical Director o...Show more
Last updated: 22 days ago • Promoted
RN Licensed Utilization Management Director

RN Licensed Utilization Management Director

VirtualVocations • Elizabeth, New Jersey, United States
Full-time
A company is looking for a Director, Utilization Management Support Operations.Key Responsibilities Directs the utilization management team to ensure compliance with policies and procedures for o...Show more
Last updated: 30+ days ago • Promoted
Licensed Utilization Review Clinician

Licensed Utilization Review Clinician

VirtualVocations • Elizabeth, New Jersey, United States
Full-time
A company is looking for a Utilization Review Clinician - ABA.Key Responsibilities Evaluates member's care and health status related to Applied Behavioral Analysis (ABA) services to ensure medica...Show more
Last updated: 30+ days ago • Promoted
Tennessee RN Utilization Review

Tennessee RN Utilization Review

VirtualVocations • Newark, New Jersey, United States
Full-time
A company is looking for an RN Utilization Review.Key Responsibilities Perform clinical assessments and evaluate injured employees' treatment utilization and compliance Collaborate with healthca...Show more
Last updated: 4 days ago • Promoted
Tennessee Licensed Utilization Review Clinician

Tennessee Licensed Utilization Review Clinician

VirtualVocations • Hamilton, New Jersey, United States
Full-time
A company is looking for a Utilization Review Clinician - Behavioral Health.Key Responsibilities Evaluate member's treatment for mental health and substance abuse to ensure medical appropriatenes...Show more
Last updated: 5 days ago • Promoted
Hawaii Licensed Utilization Review Clinician

Hawaii Licensed Utilization Review Clinician

VirtualVocations • Elizabeth, New Jersey, United States
Full-time
A company is looking for a Utilization Review Clinician - Behavioral Health.Key Responsibilities Evaluates treatment for mental health and substance abuse to ensure medical appropriateness Perfo...Show more
Last updated: 3 days ago • Promoted
Travel Interventional Radiology RN in New Brunswick, New Jersey

Travel Interventional Radiology RN in New Brunswick, New Jersey

Gifted Healthcare • 08640, NJ, US
Full-time
Interventional Radiology RNs (IR RNs) are involved with the assessment, planning, and care of patients who undergo diagnostic, interventional, and therapeutic procedures. The IR RNs complete compreh...Show more
Last updated: 3 days ago • Promoted
Maine Licensed Utilization Review Nurse

Maine Licensed Utilization Review Nurse

VirtualVocations • Hamilton, New Jersey, United States
Full-time
A company is looking for a Utilization Review Nurse - Remote.Key Responsibilities Review prior authorization requests for medical necessity and manage medical claims disputes Coordinate transiti...Show more
Last updated: 30+ days ago • Promoted
Ohio Licensed Utilization Management RN

Ohio Licensed Utilization Management RN

VirtualVocations • Newark, New Jersey, United States
Full-time
A company is looking for a Utilization Management RN Reviewer.Key Responsibilities Conduct admission, concurrent, and retrospective reviews of patient charts and clinical systems Collaborate wit...Show more
Last updated: 4 days ago • Promoted
Ohio Licensed Utilization Management Nurse

Ohio Licensed Utilization Management Nurse

VirtualVocations • Newark, New Jersey, United States
Full-time
A company is looking for a Utilization Management Nurse Consultant.Key Responsibilities Assess, plan, implement, coordinate, monitor, and evaluate healthcare services for members Gather clinical...Show more
Last updated: 30+ days ago • Promoted
Minnesota Licensed Utilization Review Nurse

Minnesota Licensed Utilization Review Nurse

VirtualVocations • Newark, New Jersey, United States
Full-time
A company is looking for a Utilization Review Nurse responsible for managing pre-claim prior authorization denials for pharmacy and medical benefits. Key Responsibilities Review and assess prior a...Show more
Last updated: 2 days ago • Promoted
Occupational Medicine

Occupational Medicine

KPG Provider Services • Langhorne, Pennsylvania, US
Full-time +1
Occupational Medicine physician job in Pennsylvania : Inpatient Facility : Looking for an experienced Medical Director Occupational Medicine in the Langhorne, Pennsylvania area.Below you will find...Show more
Last updated: 30+ days ago • Promoted
Pain Management

Pain Management

GO Staffing • Toms River, New Jersey, US
Full-time
Pain Management physician job in New Jersey : .Great opportunity to work with a large Interventional Pain Management group for a clinic on the coast of Central New Jersey near Toms River.Experienced...Show more
Last updated: 30+ days ago • Promoted
DC Licensed Utilization Nurse Reviewer

DC Licensed Utilization Nurse Reviewer

VirtualVocations • Newark, New Jersey, United States
Full-time
A company is looking for a Utilization Nurse Reviewer (Remote).Key Responsibilities Conduct timely clinical chart reviews and communicate effectively with third-party payers Review admission ser...Show more
Last updated: 3 days ago • Promoted
RN

RN

Fresenius Medical Care • Holmdel, NJ, US
Full-time +1
The Inpatient RN provides direct patient care in accordance to company policies and procedures which includes FMCNA compliance programs and contracted hospitals’ policies and procedures.Areas of pr...Show more
Last updated: 11 hours ago • Promoted • New!
RN

RN

RWJ New Brunswick • New Brunswick, NJ, US
Full-time +1
Location : Bristol Myers Squibb Hospital.Department Name : Pediatric ICU.The above reflects the anticipated hourly wage range for this position if hired to work in New Jersey.The compensation offered...Show more
Last updated: 21 hours ago • Promoted • New!