Top 57426 PRN Jobs | SimplyHired

Utilization Specialist PRN
Pacific Grove —Riverside, CA
- $31 - $50 an hour
- PRN
- CPR Certification
- Nursing
- RN License
- Employee assistance program
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Millennium Home Care, LLC —Cape Coral, FL
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- Online Application
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RN Operating Room PRN
Kansas City Orthopaedic Institute —Leawood, KS
- 10 hour shift
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CT Technologist PRN
Mission Hospital —Asheville, NC
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X-Ray Technician (Multiple schedule options available)
Olympia Orthopaedic Associates —Olympia, WA
- $29.00 - $39.40 an hour
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Quick Apply
Surgical Technologist
Upper Mississippi Surgery Center LLC —Hazel Green, WI
- Part-time
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- Mid-level
- Health insurance
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RN Float FT/PT/PRN
South Coast Hospice & Palliative Care Services, Inc. —Coos Bay, OR
- $40 - $45 an hour
- Part-time
- Background check
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Nuclear Med Technologist-Nuclear Medicine
Kettering Health —Hamilton, OH
- PRN
- Hospital
- BLS Certification
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Therapist (LPC/LCSW) - PRN
Signet Health Corporation —Coushatta, LA
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Mammographer PRN
Texas Health Resources —Arlington, TX
- Email
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Registered Nurse Case Manager
OPTIMAL HOSPICE CARE —Lakewood, CO
- $92,000 - $98,000 a year
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- CPR Certification
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Registered Nurse (RN)
Team Select Home Care —Spokane, WA
- $38 - $42 an hour
- Part-time
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14d
Licensed Social Worker
Islands Hospice —Maui, HI
- $40 - $43 an hour
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DIETITIAN FOR HOSPITAL PRN VARIABLE SHIFTS
AMG SPECIALTY HOSPITAL ‑ HOUMA —Houma, LA
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HHA/PCA Home Health Aide in Beacon NY- Cases Available Immediately
AllCare HomeCare, LLC —Beacon, NY
- $15.50 - $17.50 an hour
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Bilingual Speech Language Pathologist (WITH SIGN ON BONUS) - Greater Inwood/Jersey Village
THERAPY 2000 —Spring Branch, TX
- Part-time
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PRN Medical Social Worker
Monarch Hospice of Nebraska —Omaha, NE
- $33 - $38 an hour
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Pediatric Nurse - Home Care - RN (Mankato Area)
Team Select Home Care —Mankato, MN
- $43 - $47 an hour
- 12 hour shift
- RN License
- Experience working with children
- Children
- Health insurance
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Quick Apply

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Utilization Specialist PRN

Pacific Grove -
Riverside, CA

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Job Details

PRN
$31 - $50 an hour

Benefits

Employee assistance program

Qualifications

CPR Certification
BLS Certification
High school diploma or GED

Full Job Description

Overview:

Pacific Grove Hospital in Riverside, CA., is a leader in behavioral healthcare, providing superior healthcare treatment to the people, communities, and military installations we serve. We are a private inpatient 68 bed acute psychiatric facility with out-patient services, dedicated to the treatment of behavioral health and substance abuse services. Come join TEAM PGH as a UR Specialist!

Flexible scheduling
Competitive Pay
Employee Assistance Program (EAP)

Hourly pay range: $31-50 DOE and licensure held

PURPOSE STATEMENT:

Proactively monitor utilization of services for patients to optimize reimbursement for the facility.

Responsibilities:

ESSENTIAL FUNCTIONS:

Act as liaison between managed care organizations and the facility professional clinical staff.
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
Conduct quality reviews for medical necessity and services provided.
Facilitate peer review calls between facility and external organizations.
Initiate and complete the formal appeal process for denied admissions or continued stay.
Assist the admissions department with pre-certifications of care.
Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.

OTHER FUNCTIONS:

Perform other functions and tasks as assigned.

Qualifications:

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

Required Education: High school diploma or equivalent.
Preferred Education: Associate's, Bachelor's, or Master’s degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred

LICENSES/DESIGNATIONS/CERTIFICATIONS:

Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
First aid may be required based on state or facility requirements.

ADDITIONAL REGULATORY REQUIREMENTS:

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.

Apply Now

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