Talent.com
Utilization Management Nurse RN
Utilization Management Nurse RNVirtualVocations • Naples, Florida, United States
Utilization Management Nurse RN

Utilization Management Nurse RN

VirtualVocations • Naples, Florida, United States
2 days ago
Job type
  • Full-time
Job description

A company is looking for a Utilization Management Nurse RN.

Key Responsibilities

Compose well-structured appeal letters using data extraction and appropriate medical literature references

Ensure compliance with HIPAA confidentiality requirements and company policies

Collaborate with peers and maintain organization within the team while meeting quality and productivity expectations

Required Qualifications

Associate's Degree (or higher)

Active and unrestricted Registered Nurse license in the state of residence

3+ years of bedside nursing experience in ED / telemetry / ICU / CCU

Advanced proficiency with Microsoft software and internet navigation

Ability to type at least 45 words per minute

Create a job alert for this search

Utilization Management Rn • Naples, Florida, United States

Related jobs
Compact Licensed Disease Management Nurse

Compact Licensed Disease Management Nurse

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for a Disease Management Nurse - Remote.Key Responsibilities Provide telephonic and omni-channel support to participants in the Disease Management program Educate participan...Show more
Last updated: 2 days ago • Promoted
RN Appeals Nurse Consultant

RN Appeals Nurse Consultant

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for an Appeals Nurse Consultant - Work From Home.Key Responsibilities Review and resolve clinical appeals by interpreting data and applying clinical criteria Coordinate clin...Show more
Last updated: 30+ days ago • Promoted
Utilization Management Coordinator

Utilization Management Coordinator

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for a Utilization Management Intake Coordinator.Key Responsibilities Handles incoming authorization requests efficiently and accurately Determines authorization requirements...Show more
Last updated: 30+ days ago • Promoted
Maine Licensed Utilization Management Nurse

Maine Licensed Utilization Management Nurse

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for a Utilization Management Nurse RN - Remote.Key Responsibilities Validates authorization for procedures and manages concurrent cases to resolution Conducts medical necess...Show more
Last updated: 1 day ago • Promoted
Licensed Utilization Review Nurse

Licensed Utilization Review Nurse

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for a Utilization Review Nurse.Key Responsibilities Perform prospective, concurrent, and retrospective utilization reviews using evidence-based guidelines Evaluate severity ...Show more
Last updated: 1 day ago • Promoted
Remote RN Preservice Review Nurse

Remote RN Preservice Review Nurse

VirtualVocations • Naples, Florida, United States
Remote
Full-time
A company is looking for a Preservice Review Nurse RN, Remote in CST, MST, or AZ Time Zone.Key Responsibilities Assess and interpret customer needs and requirements Identify solutions to non-sta...Show more
Last updated: 17 days ago • Promoted
RN Outcomes Specialist

RN Outcomes Specialist

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for an Outcomes Specialist.Key Responsibilities Identify and implement operational performance improvement projects aligned with organizational goals Collaborate with variou...Show more
Last updated: 1 day ago • Promoted
Texas Licensed RN Manager

Texas Licensed RN Manager

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for a Manager of Prior Authorization UM - Aetna Medicaid Texas - RN.Key Responsibilities Lead and manage the prior authorization team, including hiring, training, and perform...Show more
Last updated: 2 days ago • Promoted
RN Manager - CA, CO, HI, IL, MA, MD, NJ, NM, NY, OR, WA

RN Manager - CA, CO, HI, IL, MA, MD, NJ, NM, NY, OR, WA

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for an RN Manager to lead and manage a team of nurses in a remote clinical environment.Key Responsibilities Oversee day-to-day clinical operations and ensure delivery of safe...Show more
Last updated: 1 day ago • Promoted
Michigan Licensed Utilization Review Nurse

Michigan Licensed Utilization Review Nurse

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for a Michigan Utilization Review Nurse - LPN (100% Remote).Key Responsibilities Perform Utilization Review to determine the medical necessity of services for Michigan Auto N...Show more
Last updated: 30+ days ago • Promoted
Oncology Nurse Navigator RN

Oncology Nurse Navigator RN

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for an Oncology Nurse Navigator.Key Responsibilities Meet with Members and caregivers to review treatment goals and address concerns throughout the cancer journey Guide and ...Show more
Last updated: 30+ days ago • Promoted
North Carolina RN Care Manager

North Carolina RN Care Manager

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for an RN Care Manager to develop and facilitate complex care management activities for members with physical needs. Key Responsibilities Evaluate member needs and barriers to...Show more
Last updated: 2 days ago • Promoted
New York RN Clinical Review Nurse

New York RN Clinical Review Nurse

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for an RN Clinical Review Nurse - Concurrent Review.Key Responsibilities Performs concurrent reviews to determine overall health and appropriate level of care for members Re...Show more
Last updated: 1 day ago • Promoted
Registered Nurse - Utilization Management

Registered Nurse - Utilization Management

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for a Per Diem Utilization Management Registered Nurse - Remote.Key Responsibilities Review and extract pertinent case details from patient medical records and compose appeal...Show more
Last updated: 7 hours ago • Promoted • New!
Utilization Review Specialist

Utilization Review Specialist

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for a Utilization Review Specialist.Key Responsibilities Review and process Independent Review (IR) requests for potential conflicts of interest Request and organize additio...Show more
Last updated: 13 hours ago • Promoted • New!
New Hampshire Licensed RN

New Hampshire Licensed RN

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for an RN Medication Access Prior Auth Nurse for their Medication Clinic.Key Responsibilities Reviews and submits requests for medication prior authorization Retrieves presc...Show more
Last updated: 15 hours ago • Promoted • New!
Maine Licensed Utilization Review Nurse

Maine Licensed Utilization Review Nurse

VirtualVocations • Naples, Florida, 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 claims disputes Collaborate with healthcar...Show more
Last updated: 30+ days ago • Promoted
RN Clinical Coordinator

RN Clinical Coordinator

VirtualVocations • Naples, Florida, United States
Full-time
A company is looking for a Senior Clinical Administrative Coordinator RN - Remote in MST.Key Responsibilities Manage the initial patient intake process, ensuring timely verification, assessment, ...Show more
Last updated: 9 days ago • Promoted