Top 26 Utilization management Jobs in Miami Ok

Registered Nurse / MDS Coordinator
Westgate Skilled Nursing and Memory Care —Joplin, MO
- From $34 an hour
- Full-time
- Nursing
- Anatomy knowledge
- RN License
- Health insurance
- Dental insurance
Quick Apply
2d
RN Care Manager Weekend
Mercy —Joplin, MO
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Dental insurance
Utilization Review Coordinator
Freeman —Joplin, MO
- Full-time
- Hybrid work
- RN License
- Mid-level
- ER
- Wellness program
- Health insurance
Brain Injury Waiver (BIW) Service Coordinator
The Independent Living Center, Inc —Joplin, MO
- $19 - $20 an hour
- Full-time
- Background check
- Customer service
- Office
- Health insurance
- Dental insurance
Quick Apply
Assistant Director of Clinical Operations (DDS/DMD)
Kansas City University —Joplin, MO
- Full-time
- Dental office
- Doctoral degree
- Customer service
Breast Imaging Program Manager - Women's Center
Freeman —Joplin, MO
- Full-time
- 5 years
- Senior level
- Radiology
- Wellness program
- Health insurance
Physical Therapist Assistant - Outpatient
Saint Francis Health System —Vinita, OK
- Full-time
- Computer literacy
- Physical & Rehabilitation Medicine
- Outpatient
RN, Registered Nurse, Vinita Medical Unit
Saint Francis Health System —Vinita, OK
- Full-time
- Nursing
- RN License
- Hospital
RN, Registered Nurse, Vinita Senior Behavioral (Renaissance)
Saint Francis Health System —Vinita, OK
- Full-time
- Nursing
- RN License
- Discharge planning
7d
Remote Physician (MD/DO), PMR or Neurology, Outpatient Prior Authorizations (REMOTE/FT) (IC to FTE)
Virtix Health —United States
- $125 an hour
- 8 hour shift
- Remote
- Background check
- Medicine
- Doctoral degree
- Work from home
Quick Apply
Physician Assistant/Nurse Practitioner (D), CVOR - Regional
Corewell Health —United States
- Weekends as needed
- Acute care
- Nursing
- Surgery
- Free parking
- Paid holidays
Advanced Practice Provider Lead (NP or PA) – NJ Palliative Care
NJ Palliative Care Solutions —United States
- $160,000 - $190,000 a year
- Full-time
- Bilingual
- 5 years
- Outpatient
Quick Apply
9d

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RN Care Manager Weekend
Mercy —Joplin, MO
Current RN License in the state of employment. The Care Management model provides effective transition planning and length of stay oversight while encompassing…

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Director, Inpatient Coding and Compliance
The Ohio State University —Columbus, OH
The information collected and used by medical information management staff is interconnected with the clinical and business systems of the health system and is…
14d
RN, LSW, LISW, Care Manager
Careforth —Columbus, OH
Ability and flexibility to travel (usually by car) within assigned geographic area; valid driver’s license and car insurance required.
$68,700 - $84,200 a year
6d

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utilization management jobs near miami ok

Registered Nurse / MDS Coordinator

Westgate Skilled Nursing and Memory Care -
Joplin, MO

Quick Apply

Job Details

Full-time
From $34 an hour
2 days ago

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Life insurance

Qualifications

Collaborate with healthcare professionals
Anatomy knowledge
RN License
Coding for hospital billing
HIPAA
EMR/EHR
Health information regulatory compliance
Multidisciplinary team collaboration for treatment planning
Health information management
Medical data abstraction
Clinical confidentiality policies
Clinical documentation standards
Medical terminology

Full Job Description

Overview
We are seeking a dedicated and detail-oriented Registered Nurse / MDS Coordinator to join our healthcare team. In this vital role, you will oversee the comprehensive assessment and documentation of patient care needs, ensuring compliance with regulatory standards such as NCQA (National Committee for Quality Assurance) and Medicare requirements. Your expertise will drive clinical documentation improvement, facilitate accurate coding, and support optimal patient outcomes in a long-term care setting. This position offers an exciting opportunity to impact patient care quality while working with an advanced EMR (Electronic Medical Record) system. Your leadership in managing MDS (Minimum Data Set) processes will be instrumental in maintaining high standards of health information management and medical documentation accuracy.

Duties

Lead the completion and review of MDS assessments to ensure accurate reflection of patient conditions, supporting quality metrics and reimbursement processes.
Collaborate with interdisciplinary teams—including nursing, therapy, social work, and medical staff—to develop individualized care plans aligned with clinical documentation improvement initiatives.
Ensure compliance with HIPAA regulations by safeguarding patient information during documentation review and data entry processes.
Utilize EMR to document patient data accurately and efficiently.
Conduct utilization review and utilization management activities to optimize resource use while maintaining compliance with Medicare, Medicaid, and managed care standards.
Perform coding using ICD-10/ICD-9/ICD coding conventions and CPT coding procedures to support billing accuracy and reimbursement efforts.
Coordinate discharge planning and case management activities for inpatient, outpatient, hospice, or home care patients to facilitate smooth transitions of care.
Maintain thorough medical records and ensure all documentation aligns with NCQA standards for quality assurance.
Support clinical staff with physiology knowledge, medical terminology clarification, and medical records management to enhance overall patient care delivery.

Requirements

Valid Registered Nurse (RN) license with current state licensure required.
Proven experience in MDS coordination within a skilled nursing facility or long-term care environment preferred.
Strong knowledge of ICD-10/ICD-9/ICD coding systems, CPT coding procedures, and DRG (Diagnosis-Related Group) classifications.
Critical care experience including ICU or Level I/II trauma center exposure is highly desirable.
Knowledge of HIPAA regulations related to medical records confidentiality and security protocols.
Excellent organizational skills with attention to detail for documentation review and medical records management.
Ability to work collaboratively across multidisciplinary teams in fast-paced healthcare settings.
Strong understanding of anatomy, physiology, medical terminology, and clinical documentation improvement strategies. Join our team to make a meaningful difference in patient outcomes through expert documentation management and clinical coordination!

Pay: From $34.00 per hour

Benefits:

401(k)
Dental insurance
Health insurance
Life insurance
Paid time off
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

utilization management jobs in miami ok

Registered Nurse / MDS Coordinator

RN Care Manager Weekend

Utilization Review Coordinator

Brain Injury Waiver (BIW) Service Coordinator

Assistant Director of Clinical Operations (DDS/DMD)

Breast Imaging Program Manager - Women's Center

Physical Therapist Assistant - Outpatient

RN, Registered Nurse, Vinita Medical Unit

RN, Registered Nurse, Vinita Senior Behavioral (Renaissance)

Remote Physician (MD/DO), PMR or Neurology, Outpatient Prior Authorizations (REMOTE/FT) (IC to FTE)

Physician Assistant/Nurse Practitioner (D), CVOR - Regional

Advanced Practice Provider Lead (NP or PA) – NJ Palliative Care

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