8947 utilization review nurse jobs found

Description Telecare's mission is to deliver excellent and effective behavioral health services that engage individuals in recovering their health, hopes, and dreams. Telecare continues to advance cultural diversity, humility, equity, and inclusion at all levels of our organization by hiring mental health peers, BIPOC, LGBTQIA+, veterans, and all belief systems. As part of the Telecare Family, t he Santa Cruz County Psychiatric Health Facility (PHF) is a 16-bed locked acute psychiatric inpatient program for adults aged 18+, diagnosed with serious mental illness (SMI), experiencing a mental health emergency and require intensive treatment and support. The CSP is a locked crisis program. It serves adults 18+ admitted both voluntarily and involuntarily. The length of stay is up to 23 hours. Shifts Available: Part Time .5; AM 9:00 am - 1:00 pm; Monday - Friday Expected starting wage range is $43.04 - $53.15. Telecare applies geographic differentials...

We’re a Little Different   Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.” Overview:   Utilization Management for the assigned inpatient Care Management population. This PRN  position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial components; promoting integration of a seamless care model; assisting with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice Qualifications: Experience: 2-3 years acute care hospital setting, Minimum Required. Care...

We’re a Little Different   Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.” Overview:   Utilization Management for the assigned inpatient Care Management population. This PRN  position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial components; promoting integration of a seamless care model; assisting with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice Qualifications: Experience: 2-3 years acute care hospital setting, Minimum Required. Care...

We’re a Little Different   Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.” Overview:   Utilization Management for the assigned inpatient Care Management population. This PRN  position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial components; promoting integration of a seamless care model; assisting with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice Qualifications: Experience: 2-3 years acute care hospital setting, Minimum Required. Care...

We’re a Little Different   Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.” Overview:   Utilization Management for the assigned inpatient Care Management population. This PRN  position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial components; promoting integration of a seamless care model; assisting with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice Qualifications: Experience: 2-3 years acute care hospital setting, Minimum Required. Care...

We’re a Little Different   Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.” Overview:   Utilization Management for the assigned inpatient Care Management population. This PRN  position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial components; promoting integration of a seamless care model; assisting with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice Qualifications: Experience: 2-3 years acute care hospital setting, Minimum Required. Care...

We’re a Little Different   Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.” Overview:   Utilization Management for the assigned inpatient Care Management population. This PRN  position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial components; promoting integration of a seamless care model; assisting with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice Qualifications: Experience: 2-3 years acute care hospital setting, Minimum Required. Care...

We’re a Little Different   Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.” Overview:   Utilization Management for the assigned inpatient Care Management population. This PRN  position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial components; promoting integration of a seamless care model; assisting with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice Qualifications: Experience: 2-3 years acute care hospital setting, Minimum Required. Care...

We’re a Little Different   Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.” Overview:   Utilization Management for the assigned inpatient Care Management population. This PRN  position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial components; promoting integration of a seamless care model; assisting with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice Qualifications: Experience: 2-3 years acute care hospital setting, Minimum Required. Care...

We’re a Little Different   Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.” Overview:   Utilization Management for the assigned inpatient Care Management population. This PRN  position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial components; promoting integration of a seamless care model; assisting with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice Qualifications: Experience: 2-3 years acute care hospital setting, Minimum Required. Care...

We’re a Little Different   Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.” Overview:   Utilization Management for the assigned inpatient Care Management population. This PRN  position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial components; promoting integration of a seamless care model; assisting with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice Qualifications: Experience: 2-3 years acute care hospital setting, Minimum Required. Care...

We’re a Little Different   Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.” Overview:   Utilization Management for the assigned inpatient Care Management population. This PRN  position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial components; promoting integration of a seamless care model; assisting with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice Qualifications: Experience: 2-3 years acute care hospital setting, Minimum Required. Care...

We’re a Little Different   Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.” Overview:   Utilization Management for the assigned inpatient Care Management population. This PRN  position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial components; promoting integration of a seamless care model; assisting with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice Qualifications: Experience: 2-3 years acute care hospital setting, Minimum Required. Care...

We’re a Little Different   Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.” Overview:   Utilization Management for the assigned inpatient Care Management population. This PRN  position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial components; promoting integration of a seamless care model; assisting with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice Qualifications: Experience: 2-3 years acute care hospital setting, Minimum Required. Care...

Note: If you are CURRENTLY employed at Children's and/or have an active badge or network access, STOP here. Submit your application via Workday using the Career App (Find Jobs). Work Shift Day Work Day(s) Variable Shift Start Time 8:00 AM Shift End Time 4:00 PM Worker Sub-Type PRN Children’s is one of the nation’s leading children’s hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We’re committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children’s. Job Description Participates as a member of a multidisciplinary team in completing pre-screening assessments of prospective patients. Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees...

43 New Scotland Avenue Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. Salary: $65,062.40 - $107,348.80 • Completes Utilization Management and Quality Screening for assigned patients. • Applies MCG criteria to monitor appropriateness of admissions and continued stays, and documents findings based on Departmental standards. • While performing utilization review identifies areas for clinical documentation improvement and contacts appropriate department. • Identifies at-risk populations using approved screening tool and follows established reporting procedures. • Monitors LOS and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas. • Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures and follows up as indicated. • Communicates...

43 New Scotland Avenue Albany, NY 12208 Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. Salary Range: $31.28 - $51.61 per hour • Completes Utilization Management and Quality Screening for assigned patients. • Applies MCG criteria to monitor appropriateness of admissions and continued stays, and documents findings based on Departmental standards. • While performing utilization review identifies areas for clinical documentation improvement and contacts appropriate department. • Identifies at-risk populations using approved screening tool and follows established reporting procedures. • Monitors LOS and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas. • Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures and follows up as...

Albany, NY, United States Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. Salary: $65,062.40 - $107,348.80 • Completes Utilization Management and Quality Screening for assigned patients. • Applies MCG criteria to monitor appropriateness of admissions and continued stays, and documents findings based on Departmental standards. • While performing utilization review identifies areas for clinical documentation improvement and contacts appropriate department. • Identifies at-risk populations using approved screening tool and follows established reporting procedures. • Monitors LOS and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas. • Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures and follows up as indicated. • Communicates...

Albany, NY, United States Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. Salary: $65,062.40 - $107,348.80 • Completes Utilization Management and Quality Screening for assigned patients. • Applies MCG criteria to monitor appropriateness of admissions and continued stays, and documents findings based on Departmental standards. • While performing utilization review identifies areas for clinical documentation improvement and contacts appropriate department. • Identifies at-risk populations using approved screening tool and follows established reporting procedures. • Monitors LOS and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas. • Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures and follows up as indicated. • Communicates...

Albany, NY, United States Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. Salary: $65,062.40 - $107,348.80 • Completes Utilization Management and Quality Screening for assigned patients. • Applies MCG criteria to monitor appropriateness of admissions and continued stays, and documents findings based on Departmental standards. • While performing utilization review identifies areas for clinical documentation improvement and contacts appropriate department. • Identifies at-risk populations using approved screening tool and follows established reporting procedures. • Monitors LOS and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas. • Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures and follows up as indicated. • Communicates...