Utilization Review Nurse - RN, LPN, or LCSW (Remote) Job at Morgan Stephens, Remote

UFNscXNKV0d0bDlJamxiM2dnbnhpOThlS2c9PQ==
  • Morgan Stephens
  • Remote

Job Description

Job Summary:

As a Utilization Management Nurse/Social Worker, 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 Nevada Licenses 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 Nurse license or Clinical License in Nevada.
  • Associate's degree; Bachelor's degree preferred.
  • 3-5 years of acute hospital experience and 3 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: 12/10/24 

Job Tags

Similar Jobs

Lensa

Data Science Intern Job at Lensa

 ...Job Description Intermountain Health uses industry leading data science and artificial intelligence to deliver on its mission to ...  ...with the Enterprise AI Center of Enablement. This is a remote internship. Incumbent will work Monday-Friday, during regular business hours... 

Allies4Outcomes

Pitt County - Adult & Aging Services Social Worker III Posotions Job at Allies4Outcomes

 ...court. Prepare legal documentation and represent DSS in court proceedings. 3. In-Home Aide and Support Services Assess client eligibility and level of need for in-home care, personal assistance, or homemaker services. Develop and monitor care plans to support... 

L3Harris

Scientist, Space Systems - RF Design, Frequency Conversion, and LO Synthesis Job at L3Harris

 ...minimum of 12 years of prior relevant experience (Accredited course of study in Electrical Engineering, Physics, Mathematics, Computer Science, or another relevant STEM field.). Graduate Degree and a minimum of 10 years of prior related experience. In lieu of a degree,... 

Mayo Clinic

Associate Clinical Research Coordinator - Comprehensive Cancer Center Job at Mayo Clinic

 ...Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report...  ...your future. Responsibilities As an Associate Clinical Research Coordinator, you will: Coordinate non-therapeutic (i.e.... 

Aspen Dental

Dental Assistant - Entry level Job at Aspen Dental

At Aspen Dental, we put You First, offering the security and job stability that comes with working with a world-class dental...  ...you thrive in your career. When you join our team as an **Entry-Level Dental Assistant** , you will have the opportunity to give back to...