Utilization review nurse [h1.location_city]
[job_alerts.create_a_job]
Utilization review nurse • rockford il
[last_updated.last_updated_variable_hours]
Nurses are you looking for a change? Want to work no nights, no weekends, and no holidays? Be able to work from home 50% of the time once trained? Check out Hines & Associates! .Hines is a nationw...[show_more][last_updated.last_updated_1_day]
Coast Medical Service is seeking an experienced Nurse Educator Registered Nurse for an exciting Travel Nursing job in Rockford, IL.
Shift : 3x12 hr days Start Date : ASAP Duration : 13 weeks Pay : $2294...[show_more][last_updated.last_updated_30]
Registered Nurse (RN) | Cardiac Catheterization Lab.TravelNurseSource is working with Care Career to find a qualified Cath Lab RN in Marion, Illinois, 62959!.
A cardiac catheterization lab nurse has...[show_more][last_updated.last_updated_variable_days]
Registered Nurse Career Opportunity / h2pRespected and valued for your Registered Nurse skill set.Are you looking for a career thats close to your heart and close to home? For many of us, its more th...[show_more][last_updated.last_updated_variable_days]
Compensation : Varies per assignment.Thank you for your interest in becoming a Paid Product Tester.This opportunity is for completing market research opportunities with independent brands via online...[show_more][last_updated.last_updated_1_day]
Responsible to provide direct nursing care to the customer, and to supervise the day-to- day nursing activities performed by the nursing assistants.
Such supervision must be in accordance with curre...[show_more][last_updated.last_updated_30]
Join Our Mission to Transform Lives!.Our team empowers individuals and families to overcome substance use and mental health challenges through compassionate care and evidence-based therapies.If you...[show_more][last_updated.last_updated_30]
Looking for extra income but not sure where to start? We’re hiring people to explore and review online side hustles listed by FinanceBuzz.
No experience needed – just a willingness to try out differ...[show_more][last_updated.last_updated_variable_days]
Nurse First is seeking a travel nurse RN Cardiac Cath Lab for a travel nursing job in Rockford, Illinois.Job Description & Requirements.
Pay package is based on 12 hour shifts and 36 hours per week ...[show_more][last_updated.last_updated_variable_days]
Monday-Friday, 8 : 00 AM to 4 : 30 PM.You will work at the UW Health Swedish American Hospital.Additional components of compensation may include : .
Evening, night, and weekend shift differential.At UW He...[show_more][last_updated.last_updated_30]
Clinical Member Services Reviewer.Provides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with establishe...[show_more][last_updated.last_updated_variable_days]
In this position you will be working with a team of independent and autonomous Intake Coordinators and Utilization Review Nurses to break down barriers and ensure quality and timely determinations ...[show_more][last_updated.last_updated_1_day]
Join Our Mission to Transform Lives!.Our team empowers individuals and families to overcome substance use and mental health challenges through compassionate care and evidence-based therapies.If you...[show_more][last_updated.last_updated_30]
Jackson Nurse Professionals is seeking a travel nurse RN Long Term Acute Care for a travel nursing job in Rockford, Illinois.
Job Description & Requirements Specialty : Long Term Acute Care Disciplin...[show_more][last_updated.last_updated_variable_hours]
Nurses - are you looking for a change? Want to work no nights, no weekends, and no holidays? Be able to work from home 50% of the time once trained? Check out Hines & Associates!.Hines is a nationw...[show_more][last_updated.last_updated_30]
Access Utilization Review Supervisor.Join Our Mission to Transform Lives! At Rosecrance, we've been leading the way in behavioral health services for over a century.
Our team empowers individuals an...[show_more][last_updated.last_updated_variable_days]
Job Leads are potential openings we are willing to investigate for you.By completing this form, you are indicating to us that you are interested in exploring this opportunity in greater depth : Appr...[show_more][last_updated.last_updated_30]
Reliable Nurse Staffing is seeking a travel nurse RN Home Health for a travel nursing job in Rockford, Illinois.Job Description & Requirements Specialty : Home Health Discipline : RN Start Date : 02 / 2...[show_more][last_updated.last_updated_variable_days]
Wellspring Nurse Source is seeking a travel CT Technologist for a travel job in Rockford, Illinois.Job Description & Requirements.
Wellspring Nurse Source Job ID #35105504.Pay package is based o...[show_more][last_updated.last_updated_30]
Utilization Review Registered Nurse
Hines & Associates IncRockford, IL, US[job_card.full_time]
Travel Nurse - Registered Nurse - Nurse Educator - $2294 / Week
Coast Medical ServiceRockford, IL, US[job_card.full_time]
- [promoted]
Travel Nurse RN - Cardiac Catheterization Lab - $3,326 per week
Travel Nurse SourceRockford, IL, United States[job_card.full_time]
Registered Nurse
Encompass Health Rehabilitation Hospital of KatyRockford, IL, United States[job_card.full_time] +1
- [promoted]
Paid Product Tester
Product Review JobsMachesney Park, IL, US[job_card.full_time]
- [promoted]
Staff Nurse (Licensed Practical Nurse)
The Alden NetworkCherry Valley, IL, United States[job_card.full_time]
Access Utilization Review Supervisor
Rosecrance Health NetworkRockford[job_card.full_time]
- [promoted]
Flexible Online Opportunity - Discover & Review Work-from-Home Gigs
Finance BuzzCherry Valley, Illinois, US[filters.remote]
[job_card.temporary]
- [promoted]
Travel Nurse RN - Cardiac Cath Lab - $2,299 per week
Nurse FirstRockford, IL, USA[job_card.full_time]
- [promoted]
Utilization Management RN
UW HealthRockford, IL, United States[job_card.full_time]
Care Review Clinician (RN) (Must Reside in IL)
Molina HealthcareRockford, IL, United States[job_card.full_time]
- [promoted]
Utilization Review Supervisor
GuidehealthRockford, Illinois, USA[job_card.full_time]
Access Utilization Review Supervisor
Rosecrance Inc.Rockford, IL, US[job_card.full_time]
Travel Nurse RN - Long Term Acute Care - $2,406 per week
Jackson Nurse ProfessionalsRockford, IL, United States[job_card.full_time]
- [promoted]
Utilization Review Registered Nurse
Hines and AssociatesRockford, IL, United States[job_card.full_time]
Access Utilization Review Supervisor
RosecranceRockford, IL, United States[job_card.full_time]
Appraiser Review Officer IL ID68064
Adams, Inc.IL, US[job_card.full_time]
Travel Nurse RN - Home Health - $2,487 per week
Reliable Nurse StaffingRockford, IL, United States[job_card.full_time]
- [promoted]
Travel CT Technologist
Wellspring Nurse SourceRockford, IL, US[job_card.full_time]
Utilization Review Registered Nurse
Hines & Associates IncRockford, IL, US[job_card.1_day_ago]
[job_preview.job_type]
- [job_card.full_time]
[job_card.job_description]This is a Monday through Friday position, 9 : 30 AM to 6 : 00 PM. Completes first level reviews within the scope of practice relevant to the clinical area(s) addressed in the initial clinical review. General Medical-Surgical nursing is sufficient to be relevant to the clinical areas addressed in most initial clinical reviews. . Demonstrates ability to assess a patients current medical status, including complications and untoward events, which may require additional intervention. Provides certification of medical, disability and workers compensation cases. Demonstrates a thorough understanding of criteria sets and their limitations including when a second level review is required. Evaluates appropriateness of current plan of care. Assesses aftercare needs, implements discharge planning and / or case management referral in a timely manner. Maintains knowledge of current advances and trends in medical care. Demonstrates knowledge of URAC guidelines, Hines policies and procedures, and standards of practice and their revisions. Able to attain and maintain the minimal quality assurance performance standards. Demonstrates assertiveness in completion of precertification and concurrent review within the guidelines of URAC, disability, workers compensation regulations, and state and federal requirements and according to the Hines policies and procedures. Performs onsite evaluations as needed or requested. Additional responsibilities as assigned. Communicates with hospital staff, physicians, other providers and Hines customer contacts in a competent, calm, effective and professional manner. Effectively communicates the need to refer to a higher-level review for questionable plans of treatment. Provides written documentation concerning the clinical information obtained regarding the patients status, benefit and claim concerns, and validation of criteria. Communicates knowledge of policies and procedures, URAC guidelines, disability and workers compensation regulations, state and federal requirements, and standards of practice. Participates in self-evaluation by identifying areas of strength and limitations and offers and accepts constructive criticism. Creative and assertive. All First Level Reviewers are required to sign and honor a confidentiality statement at the time of hire and annually at the time of performance reviews. Registered Nurse with valid, unrestricted, current nursing license in the state or territory of the United States where employed. For mental health / substance abuse, licensed medical professional with an unrestricted license in the state or in a state that has licensure reciprocation with the state of the office location the employee is working in may perform first level reviews. Accepted licensure includes but is not limited to RN, LMSW, LMHC. Successful completion of UR nurse orientation program. Minimum of 3 years recent acute clinical practice required, 5 years preferred. Managed care, disability or workers compensation experience helpful but not mandatory. Customer service oriented. Hines welcomes diversity and as an equal opportunity employer all qualified applicants will be considered regardless of race, religion, color, national origin, sex, age, sexual orientation, gender identity, disability or protected veteran status.
Description :
Nurses are you looking for a change? Want to work no nights, no weekends, and no holidays? Be able to work from home 50% of the time once trained? Check out Hines & Associates!
ABOUT US :
Hines is a nationwide, independent leader in personalized managed health care, focused on whats important to youcomprehensive services with the program excellence and cost containment that you demand. Hines & Associates, Inc.s reputation as an industry leader is founded on over three decades of innovative and professional health care excellence. Serving all aspects of the industry, Hines is committed to conserving health care dollars while ensuring quality care through effective programs and personalized service.
WHAT WE OFFER :
- Competitive salary and benefits, including medical, dental, vision, long-term care, short-term disability, long-term disability, company paid and voluntary life insurance. Critical Illness, accident insurance and flexible spending also available!
- 401k plan with company match, fully vested after 1 year.
- No weekends and nights!
- Paid Holidays
- Work-life balance.
- Remote / hybrid setting (once trained)
ROLE DESCRIPTION :
This individual will utilize clinical knowledge and communication skills to obtain patient specific information regarding patient condition and proposed treatments and procedures to determine if illness and / or proposed services meet acceptable criteria sets and acceptable nursing practice guidelines for outpatient treatment or inpatient confinement. This individual will certify treatment for confinement when criteria and / or practice guidelines are met, in accordance with the health benefit plan, disability, workers compensation regulations and state and federal regulations. If these conditions do not appear to be met, this individual will defer decision to a second level reviewer. This individual interfaces with case managers and disease management nurses on active cases involved in other Hines programs.
RESPONSIBILITIES AND PERFORMANCE :
COMMUNICATION :
PERSONAL AND PROFESSIONAL :
PM21
Requirements : QUALIFICATIONS :
Compensation details : 57244-62180 Yearly Salary
PI84c31ab34b86-31181-34548457