6 utilization review nurse rn jobs found

Location: Avera Health Plans Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $31.00 - $46.25 Position Highlights You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Specialized nurse that identifies members who would benefit from complex/chronic condition case management and/or service coordination. The RN Case Manager develops and facilitates the member's plan of care. In collaboration with physicians, population health staff, employers, community organizations, hospital-based case managers/utilization review staff, clinic-based care coordinators/preauthorization staff, and Insurance Division staff, the RN Case Manager encourages the best possible outcome in the most cost...

Location: Le Mars, IA Worker Type: Regular Work Shift: Day Shift (United States of America) Floyd Valley Healthcare is proud to offer a positive and fulfilling work environment that supports a healthy work-life balance. We understand that our employees have choices, and we strive to be an employer of choice for our team. Position Highlights Come join our award-winning team at Floyd Valley Healthcare as a Centralized Prior Authorization Department Nurse (RN or LPN). Floyd Valley Healthcare in Le Mars, IA has a full-time Centralized Authorization Nurse (RN or LPN) position (40 hours per week). Floyd Valley offers a positive culture that supports a healthy work-life balance. Our Mission is to be a progressive healthcare partner serving with compassion, integrity and excellence. Responsibilities: Determine eligibility for all applicable payors by obtaining prior authorization from insurers for medical tests, procedures, surgeries and any other...

Location: Scotland, SD Worker Type: Regular Work Shift: Day/Evening/Weekend/Holiday Shift (United States of America) Landmann-Jungman Memorial Hospital Avera is seeking a qualified individual to join our team! We offer quality care close to home. Position Highlights Position Description Job Code/Title: Registered Nurse General hours of work: Rotating Shifts Exempt/nonexempt: Non-exempt (hourly) Department/Unit: Nursing Services Reports To: Director of Patient Care Services Revision/Review Date: January 2023 SUMMARY: Nursing Services at Landmann-Jungman Memorial Hospital requires all nurses to practice at a competent level of nursing care and demonstrate a competent and professional level of behavior in her/his role as an RN. The American Nurses Associations (ANA) scope and standards of practice are exemplified within the position description. The Staff RN is responsible for utilizing the Nursing Process to provide nursing care for...

Location: Avera Home Infusion Pharmacy-Sioux Falls Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $31.00 - $46.25 Position Highlights Monday-Friday, 8:00am-5:00pm; 80hrs/2wks You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview ​​​​Collaborates with the multidisciplinary care team to bring together an established plan for patient treatments, assists with the transitions between levels of care, to promote the best possible patient outcome. The case manager facilitates efficient utilization of resources and identifies patient care needs throughout the continuum of care. What you will do Acts as liaison with hospitals and other health care service to provide treatment...

Location: Avera McKennan Hospital Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $31.00 - $46.25 Position Highlights Day shift You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Responsible for reviewing and analyzing information for medical necessity criteria for both internal and external transfers within the Avera system. Serves as a liaison for any communication between sending hospitals' case managers and providers and Avera Transfer Center RN and accepting physician. The Transfer Center Case Manager reviews patients for medical necessity, including both the level of care and the status, for any patient transferred into the hospital for acute care. This role will also...

Location: Avera McKennan Hospital Worker Type: PRN Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $31.00 - $46.25 Position Highlights Day shift as needed; PRN You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Responsible for reviewing and analyzing information for medical necessity criteria for both internal and external transfers within the Avera system. Serves as a liaison for any communication between sending hospitals' case managers and providers and Avera Transfer Center RN and accepting physician. The Transfer Center Case Manager reviews patients for medical necessity, including both the level of care and the status, for any patient transferred into the hospital for acute care. This role will...