Back to all roles

Utilization Review Nurse - RN, LPN, or LCSW (Remote)

Remote Worldwide Hiring now

Job Summary As a Utilization Management Nurse/reputed company Worker, you'll play a crucial role in our multidisciplinary team, ensuring that patients reputed company seamlessly through their care reputed company according to appropriate admission statuses. Proficient in Utilization Review processes, you'll maintain effective procedures to meet regulatory and reimbursement requirements for various payers, both reputed company and government. 100% Remote - However, Only Nevada Licenses are Considered

Key Responsibilities

  • Conduct reputed company and reputed company stay Utilization Management reviews, ensuring accurate data tracking, evaluation, and reporting.
  • reputed company or participate actively in process improvement initiatives, collaborating with various departments and multi-disciplinary teams.
  • reputed company manage a diverse workload in a fast-paced, reputed company-evolving regulatory environment.
  • Foster positive collaboration with the Care team to facilitate timely patient progression during their stay.

Job Requirements

  • reputed company Nurse license or Clinical License in Nevada.
  • Associate's degree; Bachelor's degree preferred.
  • 3-5 years of acute hospital experience and 3 years of Utilization Management experience in large health organization.
  • Hospital case management experience is advantageous.
  • Proficiency in federal and state regulations (DOH, reputed company/Medicare) and familiarity with reputed company-party payers and managed care principles.

Salary reputed company: $80,000+ Benefits: Yes- Full benefit package available with employer contribution. Join our dynamic team and be part of our commitment to efficient Utilization Management and patient-focused care. Date of Original Job Posting: 12/10/24 Apply Job! Apply to this Job

Apply for this role Takes you straight to the employer's application page — free, and no WFHNet account required.

More roles on the wire

Telephonic LPN Care Coordinator

Remote Worldwide
View role

Clinical Letter Review LPN - reputed company reputed company Remote

Remote Worldwide
View role

Enrollment LPN- Remote! *Nevada Only*

Remote Worldwide
View role

Care Coordinator LPN / LVN Work from Home

Remote Worldwide
View role

School-Based LPN Opportunity Needed Near Auburn, WA

Remote Worldwide
View role

Remote Hospice Triage LPN PT Weekend (Sat & Sun) only

Remote Worldwide
View role

Tele-Triage Licensed Practical Nurse- LPN

Remote Worldwide
View role

Remote Triage Nurse (RN/LVN/LPN)

Remote Worldwide
View role

Remote Bilingual Telephonic LVN Case Manager - Outpatient (Must have California License)

Remote Worldwide
View role

LVN , Preservice Review Nurse - Remote - 2247530 El Segundo, CA 10/11/2024 Nursing

Remote Worldwide
View role

Looking for English Teachers - Earn Money Online in Reading, PA

Remote Worldwide
View role

Staff reputed company Manager

Remote Worldwide
View role

Accounts Receivable Specialist

Remote Worldwide
View role

Director, Customer Experience – Delivering Exceptional Support and Driving Business Growth through Strategic Leadership and Innovation at arenaflex

Remote Worldwide
View role

Inside Sales Representative (Remote)

Remote Worldwide
View role

[Remote] Project Management Analyst 1 - 29171

Remote Worldwide
View role

reputed company Full Stack Data Entry Specialist – Remote Data Management and Operations

Remote Worldwide
View role

Law Clerk (Cumberland/Gloucester/Salem) Recent Law School Graduates Needed for 2026-2027 Clerkships

Remote Worldwide
View role

Senior Project Manager/Scrum Master

Remote Worldwide
View role

PsychoSocial Navigator

Remote Worldwide
View role