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

Mid-State Health Center

Limited X-Ray Technician Job at Mid-State Health Center

 ...(8am-4pm) GENERAL SUMMARY OF DUTIES: The Radiology Limited X-ray Operator is responsible for performing specific diagnostic imaging...  ...EDUCATION: Successful completion of a Limited X-Ray Technician course. LICENSE/ CERTIFICATION: LMXO certificate ... 

Prysmian Group

2nd Shift Production Supervisor Job at Prysmian Group

 ...facility continues to aggressively increase in productivity and it lowers its manufacturing costs, there is a need to recruit a first shift Production Supervisor to supervise and coordinate all activities of one or more major manufacturing function(s). Basic Function... 

University of South Florida St. Petersburg

Police Communications Specialist (Dispatcher) Job at University of South Florida St. Petersburg

Police Communications Specialist (Dispatcher) Location Saint Petersburg, FL : Police Communications Specialist (Dispatcher) Dept Number/Name: 3-5149-000 University Police College/Division: USFSP-Admin & Financial Svcs Salary Plan: Staff Hiring Salary/Salary... 

Domino's Franchise

Late Night Affton Delivery Driver - 8814 Gravois Rd Job at Domino's Franchise

 ...Rd When people ask how is it possible that our Domino's delivery drivers can make $43K a year it's easier to show "the math": Drivers...  ...of any company in the area. We are hiring for LATE NIGHT shifts Day Shift - 10am - 5pm Dinner Shift - 4/5pm - 9/10pm... 

Brock Canada Industrial Ltd

Insulators - LNGC Kitimat Job at Brock Canada Industrial Ltd

 ...Brock Canada Industrial Ltd is hiring Insulators of All Levels for LNGC Kitimat We are currently looking for experienced, hard-working, and motivated Insulators for maintenance at LNGC located in Kitimat BC Shift: 14&7 Hours: 10 hours a day MINIMUM REQUIREMENTS...