Talent.com
RN-Utilization Review
RN-Utilization ReviewBaptist Memorial Healthcare Corporation • Memphis, TN, United States
RN-Utilization Review

RN-Utilization Review

Baptist Memorial Healthcare Corporation • Memphis, TN, United States
30+ days ago
Job type
  • Full-time
Job description
Overview

Job Summary

Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal and other payer requirements. Provides early assessment of transitional needs identified during their hospitalization, illness, and/or life situation. Performs other duties as assigned.

Responsibilities
  • Utilization Review
  • Discharge planning
  • Readmission Reduction Participation
  • Payer Communication and denial reduction
  • Completes assigned goals.
Specifications

Experience

Minimum Required
  • RN with at least one (1) year of clinical experience
Preferred/Desired
  • RN with 3 years of clinical experience with Case Management experience in a hospital or payer setting
Education

Minimum Required
  • Diploma or Associate Degree in Nursing
Preferred/Desired
  • BSN or MSN
Training

Minimum Required

Preferred/Desired
  • Certified Case Manager
Special Skills
  • .
Minimum Required
  • Critical thinking skills, communication, organization, interpersonal and computer skills. Problem solving; and governmental regulations.
Preferred/Desired
  • Critical thinking skills, communication, organization, interpersonal and computer skills. Knowledge of payer requirements; problem solving; and governmental regulations.
Licensure
  • RN
Minimum Required
  • RN
Preferred/Desired
  • RN;CCM;ACM
Create a job alert for this search

RN-Utilization Review • Memphis, TN, United States

Similar jobs

RN Supervisor - ULPS - Le Bonheur Outpatient Allergy/Immunology - FT Day

Methodist Le Bonheur HealthcareMemphis, Tennessee, United States
Full-time

Overview If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One! We strive to be an employer of choice and establish a reputation for being a talent...Show more

 • Promoted

RN - Memphis

UnitedHealth GroupMemphis, Tennessee, United States
Full-time

Explore opportunities with Elk Valley, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide.As members of the Optum family of businesses, we are ...Show more

 • Promoted

Lead Patient Care Manager, Home Health (RN)

AccentCareSouthaven, Mississippi, United States
Full-time

A healthcare management company is seeking a Patient Care Manager in Southaven, MS.In this full-time role, you will lead a dedicated team to provide exceptional home health care.The position requir...Show more

 • Promoted

Remote RN Case Manager – Home Health (Medicaid)

BlueCross BlueShield of TennesseeMemphis, Tennessee, United States
Remote
Full-time

A leading health insurance provider is hiring a Home Health Case Manager to support Medicaid members with complex needs.This remote role requires strong clinical judgment and coordination of care t...Show more

 • Promoted

Home Health RN - 1:1 Patient Care with Flexible Scheduling

Adoration HealthMemphis, Tennessee, United States
Full-time

A compassionate home health service provider is seeking a dedicated Home Health RN to join their team in Cordova, TN.The successful candidate will provide expert, patient-centered care and work wit...Show more

 • Promoted

RN PRN Shifts: Set Your Schedule & Earn Up to $45/hr

ShiftKeyMemphis, Tennessee, United States
Full-time

A healthcare scheduling platform is seeking Registered Nurses for PRN shifts in Memphis, TN.This role offers flexibility in scheduling, allowing RNs to work as much or as little as desired with com...Show more

 • Promoted

Care Manager (RN)

Molina HealthcareSouthaven, MS, US
Full-time

Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum.Strives to ensure...Show more

 • Promoted • New!

RN Oncology (Travel)

Westways Staffing ServicesMemphis, Tennessee, United States
Full-time

Discipline RN Specialities Oncology Location Memphis, TN Shifts 12HR Night Position Acute Care, Travel Start Date 4/18/2026 Memphis, TN RN Oncology (Travel) Job Description & Information We have Tr...Show more

 • Promoted

Lead RN - Home Health Patient Care Manager

Accentcare IncSouthaven, Mississippi, United States
Full-time

A leading home health provider in Southaven is seeking a full-time Patient Care Manager.This role demands a registered nurse with managerial experience in home care and knowledge of Medicare standa...Show more

 • Promoted

RN

Baptist Memorial HealthMemphis, TN, US
Full-time

Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance wi...Show more

 • Promoted • New!

RN - Memphis

OptumMemphis, Tennessee, United States
Full-time

Explore opportunities with Elk Valley, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide.As members of the Optum family of businesses, we are ...Show more

 • Promoted

Travel Nurse RN - Home Health - $2,098 to $2,298 per week in Hernando, MS

TravelNurseSourceHernando, MS, US
Full-time

Registered Nurse (RN) | Home Health.TravelNurseSource is working with Ventura MedStaff to find a qualified Home Health RN in Hernando, Mississippi, 38632!.Are you ready to take your Travel career t...Show more

 • Promoted

CRNA

Cone HealthMemphis, TN, United States
Part-time

Sign-on bonuses up to $100,000 with a 4-year work commitment.New compensation packages at the 90th percentile based on national survey data.APP Center of Excellence opening in fall 2026.Work with u...Show more

 • Promoted

RN – Sign-On Bonus, Flexible Shifts & Growth

Signature HealthCARE TN, MemphisMemphis, Tennessee, United States
Full-time

A healthcare company in Memphis is seeking Registered Nurses (RNs) to deliver exceptional care.This role offers evening shifts and a sign-on bonus of $7,500 for full-time positions.Candidates must ...Show more

 • Promoted

Home Health RN: Impactful Care, Hybrid Role & Growth

Methodist Le Bonheur HealthcareMemphis, Tennessee, United States
Full-time

A leading healthcare provider in Memphis is seeking a Home Health RN for a hybrid role.The candidate will be responsible for providing specialized nursing care to patients, promoting evidence-based...Show more

 • Promoted

RN Clinical Supervisor - Home Health

Maxim Healthcare ServicesMEMPHIS, Tennessee, United States
Full-time

Ready to Elevate Your Nursing Career Beyond the Bedside? .Start your next chapter with $72K–$79K base pay, $5K annual bonus, weekly pay, and unbeatable benefits!.RN Clinical Supervisor - Home Healt...Show more

 • Promoted • New!

Patient Care Tech (ER) PRN II

Mississippi Baptist Health SystemsMemphis, TN, United States
Full-time

This job posting is for a position in the nursing category at BMH Memphis Hospital, specifically in the emergency room department.The purpose of the position and the scope of responsibility include...Show more

 • Promoted

Travel RN-Stepdown in Memphis, Tennessee

TEEMA Solutions GroupMemphis, Tennessee, United States
Full-time

Overview Looking to level up your career and boost your income? At Voyage Healthcare, we help connect nurses, therapists, and allied health pros with high-paying travel jobs at top-rated facilities...Show more