Utilization Review Nurse - RN, LPN, or LCSW (Remote) - #1411352

Morgan Stephens


Date: 3 weeks ago
City: Reno, NV
Contract type: Full time
Remote
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

How to apply

To apply for this job you need to authorize on our website. If you don't have an account yet, please register.

Post a resume

Similar jobs

Lift Operator (Full-Time/ Part-Time)

Mt. Rose Ski Tahoe, Reno, NV
2 days ago
Job Details Description POSITION SUMMARY The Lift Operator maintains orderly passenger traffic, advises and assists guest as needed, maintains a responsible surveillance of the particular lift station, and overall, assumes responsibility of the lift for the assigned shift. Education / Experience/ Skills And Ability Requirements Must be at least 18 years of age Excellent English Communication skills Ability to work...

Management Information Systems (MIS) Analyst Series

Truckee Meadows Water Authority, Reno, NV
2 weeks ago
About The Organization Truckee Meadows Water Authority (TMWA) is a not-for-profit, community-owned water utility, overseen by elected officials and citizen appointees from Reno, Sparks and Washoe County. TMWA has a highly skilled workforce who ensure the around-the-clock treatment, delivery and availability of high-quality drinking water for more than 475,000 residents of the Truckee Meadows. We are looking to hire a...

Advertising Coordinator

Peppermill Resort Spa Casino, Reno, NV
4 weeks ago
The Advertising Coordinator oversees all aspects of advertising campaigns and manages inside and outside advertising work orders for customers. Duties: Assist with phone inquiries, taking messages and scheduling appointments for management. Contribute with planning, execution and evaluation of all advertising materials. Create and prepare client work orders and other documents ensuring they are labelled, organized and stored to standard. Communicate...