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: $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: 5/5/25 Morgan Stephens
...patients on diagnoses, products, and services to promote visual health. Document services provided, prescriptions, treatment plans... ...and conditions. Job Type: Full-time Benefits: * Dental insurance * Employee discount * Health insurance * Life insurance...
...Job Description Job Description Salary: $15.00 Schedule: 12-Hour Shift Saturday & Sundays 7:00am - 7:00pm (DSP) DIRECT SUPPORT PROFESSIONAL are individuals who work directly with individuals with physical and/or intellectual disabilities with the aim of...
Description Summary: The competent Nurse, in the same or similar clinical setting, practices independently and demonstrates an awareness of all relevant aspects of a situation. Provides routine and complex care, with the ability to on long-range goals or plans. Continues...
...Language Interpreter (Mandarin & English) Full-time night job following US Pacific Time Zone (US Client), 5 days work a week Work... ...dedicated to live sessions, the remaining hours will be allocated for online assessments, tutorial sessions, and module study. Days 13/1...
...management experience will be considered. No other applicants will be considered. Elgin VW is seeking an experienced Used Car Manager/ Sales Manager. This is a newer facility with lots of Randall Rd traffic, just North of I90. We're a small dealership that has been...