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
...payout eligibility &##127979; Environment: Alternative Education Program, High School &##128105;&##127995;&##127979; Teaching Specialty: Math , a growing, dynamic organization with a social mission to offer hope, is seeking a Math Teacher to join our award...
...friends Training Provided Perfect hours for mom's working while kids are in school Will be part of a team or work alone to clean homes and offices Able to work a minimum of 15 hours per week. Must be willing to drive to Roseville, Granite Bay, Folsom, Rocklin...
...knowledge base by proposing new and valuable ways to approach problems and projectsOversee and direct the technical activities of junior colleaguesAdditional Information All your information will be kept confidential according to EEO guidelines.#J-18808-Ljbffr Modis
...Job Description Description: **Hybrid Remote | 2 weeks onsite per month in Westlake, TX** We are looking to source multiple Scrum Masters for our financial client. Due to client requirement, applicants must be willing and able to work on a w2 basis. For our w2...
Ardor Health Solutions is seeking a travel Certified Occupational Therapy Assistant for a travel job in Needham, Massachusetts. Job Description & Requirements ~ Specialty: Certified Occupational Therapy Assistant ~ Discipline: Therapy ~ Start Date: 10/21/202...