Clinical Review Nurse
2 weeks ago
Job Title: Utilization Review RNPay: $40 per hour Job Type: Full-time Shift Options Training going from 6 AM-3 PM PST Mon-Fri (2 weeks, NO TIME OFF)10-7 PST Tuesday-Saturday10-7 PST Sunday-Thursday8-5 PST Monday-Friday Utilization Review Case Manager RN Overview Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines.
Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member.
Specific to the denial letters.
Perform concurrent clinical reviews for healthcare plans Evaluate patient records and ensure compliance with treatment protocols Collaborate with healthcare providers to validate appropriateness of care Document findings and communicate recommendations to team Conduct reviews according to schedule and company standards Utilization Review Case Manager RN Qualifications RN with current licensure in State of residence (CA, WA, or OR)3+ years of clinical experience required2+ years' experience working with utilization review or prior authorization documentation Bachelors of Nursing (BSN) preferred Minimum of Associates or Diploma nursing degree required Utilization Review Case Manager RN Benefits Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates How To Apply If you are interested in this position, please apply OR submit your resume to:mtrubitt@alinestaffing.com Seniority level Mid-Senior level Employment type Full-time Job function Health Care Provider Industries Staffing and Recruiting Get notified about new Registered Nurse jobs in Greater Bend Area.
#J-18808-Ljbffr
-
Clinical Review Nurse
2 weeks ago
Melbourne, Victoria, Australia A-Line Staffing Solutions Full timeOverviewA-Line Staffing Solutions is hiring a remote clinical review RN with a large managed care organization working on the west coast (CA, OR, or WA).Job Title:Utilization Review RNPay:$40 per hourJob Type:Full-timeShift OptionsTraining going from 6AM-3PM PST Mon-Fri (2 weeks, NO TIME OFF)10-7 PST Tuesday-Saturday10-7 PST Sunday-Thursday8-5 PST...
-
Clinical Review Nurse
3 weeks ago
Melbourne, Victoria, Australia A-Line Staffing Solutions Full timeOverviewA-Line Staffing Solutions is hiring a remote clinical review RN with a large managed care organization working on the west coast (CA, OR, or WA).Job Title: Utilization Review RNPay: $40 per hourJob Type: Full-timeShift OptionsTraining going from 6AM-3PM PST Mon-Fri (2 weeks, NO TIME OFF)10-7 PST Tuesday-Saturday10-7 PST Sunday-Thursday8-5 PST...
-
Clinical Review Coordinator
2 weeks ago
Melbourne, Victoria, Australia beBeePsychiatry Full time $114,464 - $143,145Job Overview:The AMAH Hospital and Emergency Department combines Adult Inpatient and Consultation-Liaison and Emergency Psychiatry Services.This role focuses on clinical review of patients, timely complaint resolution and incident review management (RISKMAN).Key responsibilities include auditing completion and implementing quality projects such as Safewards...
-
Nurse Clinical Consultant
2 days ago
Melbourne, Victoria, Australia Peter MacCallum Cancer Centre Full time $120,000 - $180,000 per yearAt Peter Mac we aim to continuously improve cancer care, research and education across all cancers and for all people affected by cancer: changing lives, breaking new ground. Everything we do is underpinned by our core values, Excellence, Compassion and Innovation. Welcoming people from a wide variety of different backgrounds and experiences is critical to...
-
Clinical Consultant
4 days ago
Melbourne, Victoria, Australia Nurse Generation Full time $90,000 - $120,000 per yearExciting opportunity to advance your career into consultancy in a Permanent Full Time Role with an established Aged Care Consultancy CompanyHealth Generation is an Aged Care Consultancy company established for over 6 years. We act as a primary support mechanism for residential Aged Care organisations nationally offering tailored services to help solve...
-
Clinic Nurse
2 weeks ago
Melbourne, Victoria, Australia Nectar Brands Full time $90,000 - $120,000 per yearElevate Your Nursing Career with Nectar Nectar Brands is a leading healthcare house of brands at the forefront of Digital Health and Alternative Medicine in Australia. Recognised as Australia's #8 fastest-growing startup in 2023 by The Australian Financial Review, our portfolio includes digital health and medicinal cannabis brands, with ongoing expansion....
-
Enrolled Nurse – Clinical
2 weeks ago
Melbourne, Victoria, Australia Specialist Partners Full time $90,000 - $120,000 per yearLocation: St Kilda & South-Eastern Melbourne (to Dandenong)Employment Type: Casual role initially, working 30-40h between the office and the bedside.We are seeking an experienced and proactive Enrolled Nurse (EN) to join our team in a diverse role combining hands-on clinical care with service coordination and management responsibilities.You will be part of a...
-
Nurse Care Manager
1 week ago
Melbourne, Victoria, Australia beBeeNurse Full time $131,870 - $134,500About the RoleClinical Nurse Consultants are pivotal to clinical service and consultancy, leadership, research, education, and clinical planning and management. They play a key role in driving patient care forward.Key ResponsibilitiesLead multidisciplinary meetings to review and manage patients with extended hospital stays, identifying barriers to timely...
-
Clinical Nurse Consultant
2 weeks ago
Melbourne, Victoria, Australia Buscojobs Full timePeninsula Health is the major metropolitan health service for Frankston and the Mornington Peninsula, providing care for a population of around 300,000 people across the life continuum.Our network of hospitals and community health services deliver quality, patient-centred healthcare and services that meet the needs of our diverse community.With specialties...
-
Senior Clinical Leader
2 weeks ago
Melbourne, Victoria, Australia beBeeNursing Full time $120,000 - $140,000Job DescriptionWe are seeking an experienced Senior Clinical Leader to lead our fertility nursing department and play a pivotal role in shaping the future of fertility care.About the RoleThe Senior Clinical Leader will be responsible for building, managing, and mentoring our nursing team while ensuring that patient care remains at the heart of everything we...
