Job Description
Job Summary: As a Utilization Management Nurse, you'll play a crucial role in our multidisciplinary team, ensuring that patients progress 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 candidates on EST Time Zone are considered. Key Responsibilities: Conduct concurrent and continued stay Utilization Management reviews, ensuring accurate data tracking, evaluation, and reporting. Lead or participate actively in process improvement initiatives, collaborating with various departments and multi-disciplinary teams. Efficiently manage a diverse workload in a fast-paced, ever-evolving regulatory environment. Foster positive collaboration with the Care team to facilitate timely patient progression during their stay. Job Requirements: Current PN Nurse license Associate's degree preferred. 2 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: $75,000+ 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: 1/25/25 Morgan Stephens
Job Tags
Similar Jobs
National Security Agency
..., Close: 2026-01-18 Responsibilities The Office of Reasonable Accommodation Services has an immediate opening for Sign Language Interpreters to provide interpreting and transliterating services for Deaf and Hard of Hearing (DHH) employees. The incumbent will: Provide reasonable...
Liberty Savings Bank FSB
Liberty Savings Bank, a cornerstone in community financial services, is looking for a Human Resources Recruiter to help build and nurture our team, ensuring we attract the best talent to support our commitment to the community and excellence in banking. In this role, you...
Ward Plumbing, Heating, and Air
...Trade? We will train you. In fact, we'll pay you while you train. Ward Plumbing, Heating & Air is a fast growing, well-established HVAC & Plumbing Contractor. This is an opportunity to learn a high demand trade from the most respected HVAC & Plumbing contractor in the...
TikTok
...continues to unlock opportunities for artists and labels, with an engaged community who love to build connections with artists and their music. The Artist Partnership team is working globally and locally with artists, managers and labels to unleash the promotional and...
Planet Fitness
...90% of our management team started as an entry level team member ~ Competitive pay ~40... ...Job Description Summary The Service Desk Associate is responsible for service desk... ...Positive attitude and willingness to help others; Ability to maintain composure...