What are the responsibilities and job description for the Utilization Review Nurse - RN (Remote) position at Morgan Stephens?
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.
MUST HAVE CALIFORNIA RN LICENSE
Key Responsibilities
Benefits: Yes
Join our dynamic team and be part of our commitment to efficient Utilization Management and patient-focused care.
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.
MUST HAVE CALIFORNIA RN LICENSE
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.
- Current Nurse license or Clinical License.
- Associate's degree; Bachelor's degree preferred.
- Pediatric experience experience and 3 years of Utilization Management experience.
- Hospital case management experience is advantageous.
- Proficiency in federal and state regulations (Medicaid/Medicare) and familiarity with third-party payers and managed care principles.
Benefits: Yes
Join our dynamic team and be part of our commitment to efficient Utilization Management and patient-focused care.
Salary : $100,000
Utilization Review Nurse - LPN
Morgan Stephens -
Long Beach, CA
Utilization Review Nurse - LPN (Remote)
Morgan Stephens -
Long Beach, CA
Registered Nurse Utilization Review ** QUICK OFFER
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