12 utilization review rn jobs found

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession:  Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas:  Continuously innovate by embracing emerging technology and fostering a culture of creativity and...

Strong staffing Support when it matters most. Technology and tools that streamline patient monitoring and communication to help you work more efficiently. Robust supply chains to keep you fully equipped. Ongoing clinical education to improve your skills. As a Registered Nurse at HCA Florida Northwest Hospital, you’ll have all the staffing support, technology and resources you need to deliver safe, high-quality care—so you can focus on what you do best. *Qualified applicants are eligible for sign on bonus with approval* Job Summary and Qualifications As a Case Manager, your role will be to support patients and families through every step of their care journey. You will coordinate services, connect resources, and develop care plans that reflect each patient’s unique needs. By partnering with physicians, nurses, and department leaders, you will help ensure safe transitions, clear communication, and consistent quality across the continuum of care.  Your...

  Director Care Transition-Texas Health Fort Worth          Work location: Texas Health Fort Worth, Fort Worth, TX Core work hours: Full Time, Monday – Friday, 08:00 AM – 5:00 PM    Key Responsibilities   Strategy / Operations - Responsible for the effective daily operation of the care transition function. Responsible for providing and/or implementing strategies to improve operations and outcomes. . Determines proactive strategies and methods necessary for a high performance culture related to care transition management. Supports change management and movement toward interaction with outpatient care management. . Directs the activities of the Care Transition Managers (RN & SW). . Serves as a content expert on the following: Compliance with program expectations Mitigation activities with all clinical partners / payors as needed. Compliance requirements: Code 44 intervention, HINN letters, Second IMM, Observation letter,...

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. The Executive Director of Case Management provides strategic and operational leadership for the enterprise Case Management program across all Beth Israel Lahey Health (BILH) facilities. This role will lead the transformation of Case Management operations from a decentralized model to an integrated, centralized enterprise function with standardized processes, shared best practices, and consistent performance across all facilities. This executive-level position is responsible for developing and executing comprehensive care coordination strategies that optimize patient throughput, ensure safe and timely transitions of care, reduce avoidable readmissions, and support the organization's population health and value-based care objectives. The Executive Director partners with senior clinical and operational leaders, including the Chief Nursing Officers, Chief Medical...

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. The Director of Surgical Services provides 24/7 leadership and operational oversight for all surgical service areas, including the Operating Room, PACU, Endoscopy, Pre‑Admission Testing, Central Sterile Processing, scheduling, and inventory management. The position reports directly to the Chief Nursing Officer. This role ensures safe, efficient, and compliant patient care aligned with AORN, AAMI, TJC, and CMS standards. The Director collaborates with senior leadership, surgeons, anesthesiologists, and nursing teams to drive strategic planning, optimize block scheduling and billing practices, and achieve organizational goals related to quality, performance, productivity, and workforce engagement. Job Description: Lead Surgical Excellence at a Growing Community Hospital At Milton Hospital , we combine the personal touch of a community hospital...

DESCRIPTION OF POSITION: The Director of Clinical Case Management develops, implements and enforces policies and procedures which support the Hospital's mission, goals and objectives. SUPERVISION: Reports directly to VP of Financial Services RESPONSIBILITIES AND DUTIES: Ensures that staff complies with mandatory education, licensure requirements, mandatory health requirements, etc. Develops annual departmental budget and operates within budgetary guidelines. Recommends and ensures appropriate staffing levels. Allocates resources according to priorities. Identifies and resolves problems in a timely manner. Gathers and analyzes information skillfully. Develops alternative solutions. Generates creative solutions and attention to detail. Seeks increased responsibilities. Looks for and takes advantage of opportunities. Demonstrates persistence and follow through even when faced with adversity or challenges. Balances team and individual...

Department: 11200 Atrium Health Cleveland - Case Management Status: Part time Benefits Eligible: Yes Hou rs Per Week: 24 Schedule Details/Additional Information: Every weekend, Saturday-Sunday 7a-7p Pay Range: $35.50 - $53.25 Essential Functions Coordination...

Overview The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Discharge Planning. Including but not limited to daily review of medical records to determine appropriateness and medical necessity of admission, continued hospital stay and use of ancillary services. Responsibilities Accurately identifies through chart review of SI/IS for admit and continued stay.  Competently coordinates the overall discharges planning and social services function ensuring compliance with federal and state laws and Joint Commission of Accreditation of Hospital. Successfully ensures patients receive recommended follow-up services. Appropriately maintains a liaison with community agencies offering services to discharge patients. Professionally maintains rapport with physicians, co-workers, representatives of other organizations, and departments....

Hello, Thank you for your interest in career opportunities with the University of Mississippi Medical Center.  Please review the following instructions prior to submitting your job application: Provide all of your employment history, education, and licenses/certifications/registrations.  You will be unable to modify your application after you have submitted it. You must meet all of the job requirements at the time of submitting the application.  You can only apply one time to a job requisition.  Once you start the application process you cannot save your work. Please ensure you have all required attachment(s) available to complete your application before you begin the process. Applications must be submitted prior to the close of the recruitment. Once recruitment has closed, applications will no longer be accepted. After you apply, we will review your qualifications and contact you if your application is among the most highly qualified. Due to the...

Director of Nursing Behavioral Health   Are you looking for a rewarding career with top-notch benefits? We are looking for a qualified Manager   like you to join our Texas Health family.   Position Highlights Work location:  Texas Health Dallas Core Work hours: Monday – Friday; 8:00a-5:00p   Texas Health Presbyterian Hospital Dallas is one of North Texas's most established hospitals. As an 875 bed, full service hospital, we've served the Dallas community and surrounding areas including Lakewood, White Rock, and Highland Park since 1966 with a commitment to high quality, compassionate care.  We specialize in cancer care, cardiology, neurosciences, women's services, and emergency medicine. Our hospital is home to a renowned Level III Neonatal Intensive Care Unit (NICU), a Comprehensive Stroke Center, and a Bariatric Surgery Center of Excellence. We also offer a wide range of outpatient services, including surgery, wellness programs, and...

Hello, Thank you for your interest in career opportunities with the University of Mississippi Medical Center.  Please review the following instructions prior to submitting your job application: Provide all of your employment history, education, and licenses/certifications/registrations.  You will be unable to modify your application after you have submitted it. You must meet all of the job requirements at the time of submitting the application.  You can only apply one time to a job requisition.  Once you start the application process you cannot save your work. Please ensure you have all required attachment(s) available to complete your application before you begin the process. Applications must be submitted prior to the close of the recruitment. Once recruitment has closed, applications will no longer be accepted. After you apply, we will review your qualifications and contact you if your application is among the most highly qualified. Due to the...

Overview About the Role: The primary purpose of the Case Management Coordinator position is to coordinate the patient’s progress through the system. He/she collaborates with physicians and clinical staff to ensure resource utilization is appropriate to the patient’s clinical and psychosocial needs and that it remains within covered benefits. The Case Management Coordinator seeks creative solutions to process and system issues, which create a barrier to the delivery of medically appropriate, cost-effective care. He/she is responsible to ensure compliance with regulatory standards related to level of care determinations, utilization and discharge planning. The Case Management Coordinator performs transitions of care and discharge planning, and supports the mission of University Hospital. Responsibilities What You’ll Do: Service provided is patient centered; actively contributes to creating a friendly, welcoming and...