Utilization Review Nurse - RN, LPN, or LCSW (Remote)
Job Summary: As a Utilization Management Nurse/Social Worker, you'll play a crucial role in our multidisciplinary team, ensuring that patients reputed company seamlessly through their care journey 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 commercial 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, Medicaid/Medicare) and familiarity with third-party payers and managed care principles.
Salary Range:$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