Utilization Review Nurse - RN, LPN, or LCSW (Remote)
Utilization Review Nurse - RN, LPN, or LCSW (Remote)
Morgan Stephens
Columbus, OH
See who Morgan Stephens has hired for this role
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 candidates on EST (Eastern Time Zone) are considered.
Key Responsibilities
Benefits: Yes-Full benefit plan offered
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.
100% Remote - However, Only candidates on EST (Eastern Time Zone) 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.
- Current LPN/LVN or RN Nurse license or Clinical License.
- Associate's degree; Bachelor's degree preferred.
- 3-5 years of acute hospital experience and 3 years of Utilization Management experience.
- 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.
- Must be located in Eastern Time Zone
Benefits: Yes-Full benefit plan offered
Join our dynamic team and be part of our commitment to efficient Utilization Management and patient-focused care.
-
Seniority level
Mid-Senior level -
Employment type
Full-time -
Job function
Health Care Provider -
Industries
Staffing and Recruiting
Referrals increase your chances of interviewing at Morgan Stephens by 2x
See who you knowGet notified about new Utilization Review Nurse jobs in Columbus, OH.
Sign in to create job alertSimilar jobs
People also viewed
-
Nursing/RN Clinical Data Analyst
Nursing/RN Clinical Data Analyst
-
Lead Clinical RN Quality Assurance - Long Term Disability, Remote
Lead Clinical RN Quality Assurance - Long Term Disability, Remote
-
Appeals Nurse Consultant (Remote)
Appeals Nurse Consultant (Remote)
-
Prior Authorization Nurse
Prior Authorization Nurse
-
Clinical Review Nurse
Clinical Review Nurse
-
Outpatient RN Services Manager - Non - Remote - Sign on bonus available
Outpatient RN Services Manager - Non - Remote - Sign on bonus available
-
Nurse Auditor, Hospital Bill Audits - Remote | WFH
Nurse Auditor, Hospital Bill Audits - Remote | WFH
-
Healthcare - Medical Claim Review Nurse
Healthcare - Medical Claim Review Nurse
-
LICENSED NURSE - Remote | WFH
LICENSED NURSE - Remote | WFH
-
Utilization Review Nurse
Utilization Review Nurse
Looking for a job?
Visit the Career Advice Hub to see tips on interviewing and resume writing.
View Career Advice Hub