Top 13 Utilization review Jobs in Poplar Bluff, Mo

Care Manager RN
Poplar Bluff Regional Medical Center —Poplar Bluff, MO
- Full-time
- Nursing
- RN License
- BLS Certification
Quick Apply
8d
Appeals Professional III (Licensed Clinician)
Tanaq Support Services LLC —United States
- Full-time
- Remote
- Nursing
- RN License
- Writing skills
13d
Remote Psychologist - US Location
APN Staffing & Employment Solutions —United States
- $100,000 a year
- Full-time
- Remote
- Word processing
- Writing skills
- Mid-level
Quick Apply
2d

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Director of Imaging
Poplar Bluff Regional Medical Center —Poplar Bluff, MO
Proficiency with Google and Microsoft platforms, healthcare software systems, and data analysis tools. Bachelor's Degree in relevant field required or.
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1d
Administrator | LNHA
Current River Rehabilitation and Health Care Center —Doniphan, MO
Bachelor’s degree in nursing home administration or related field required. Current knowledge of local, state, and federal guidelines and regulations.

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UR Coordinator, Full Time
RiverVista Behavioral Hospital —Columbus, OH
High school diploma required; associate or bachelor’s degree in nursing, healthcare administration, or related field preferred. Must be 21 or older.
$24 - $32 an hour
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Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…

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utilization review jobs near poplar bluff, mo

Care Manager RN

Poplar Bluff Regional Medical Center -
Poplar Bluff, MO

Quick Apply

Job Details

Full-time
8 days ago

Qualifications

RN License
Associate's degree
Associate Degree in Nursing

Full Job Description

Job Summary

The Care Manager - RN is responsible for coordinating and overseeing discharge planning, transitions of care, and case management activities to ensure optimal patient outcomes. This role involves collaborating with interdisciplinary teams, reviewing medical records for appropriateness and medical necessity, and maintaining compliance with federal, state, and accreditation standards.

Essential Functions

Conducts daily reviews of medical records to assess the appropriateness of admission, continued hospital stay, and utilization of diagnostic services.
Collaborates with interdisciplinary teams (IDT) to ensure effective communication and coordination of patient care, including identifying avoidable days and resolving care transition issues.
Develops and implements discharge plans, coordinating post-hospital placement and social services to meet patient needs.
Refers cases to physicians or managers when patients do not meet established criteria, ensuring timely and appropriate interventions.
Serves as a liaison with community agencies, maintaining relationships and facilitating seamless transitions for discharged patients.
Facilitates interdisciplinary meetings to address patient care needs, resolve challenges, and support collaborative care planning.
Maintains accurate and timely documentation of case management activities, including records of referrals, patient interactions, and compliance with reporting requirements.
Provides assistance to patients, families, and physicians regarding discharge planning and post-hospital care options.
Performs other duties as assigned.
Maintains regular and reliable attendance.
Complies with all policies and standards.

Qualifications

Associate Degree in Nursing required
Bachelor's Degree in Nursing preferred
2-4 years of clinical nursing experience in a hospital, home health, or nursing home setting required
2-4 years of care management experience preferred

Knowledge, Skills and Abilities

Strong understanding of case management principles, discharge planning, and transitions of care.
Knowledge of federal, state, and Joint Commission standards related to case management.
Excellent communication and interpersonal skills to collaborate effectively with patients, families, and interdisciplinary teams.
Ability to assess complex situations, identify solutions, and implement care plans efficiently.
Proficiency in electronic medical records (EMR) and documentation systems.
Strong organizational and time management skills to prioritize tasks in a dynamic environment.

Licenses and Certifications

RN - Registered Nurse - State Licensure and/or Compact State Licensure state licensure in state of employment or Compact state licensure required
Accredited Case Manager (ACM) preferred
CCM - Certified Case Manager preferred
BLS - Basic Life Support preferred

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utilization review jobs in poplar bluff, mo

Care Manager RN

Appeals Professional III (Licensed Clinician)

Remote Psychologist - US Location

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