Top 3 Utilization review nurse Jobs in Albertville Al

Care Manager RN
Gadsden Regional Medical Center —Gadsden, AL
- Full-time
- Nursing
- RN License
- PALS Certification
Quick Apply
Registered Nurse | Review Analyst I | Remote | Detroit, MI | Contract
Walker Healthforce, LLC —United States
- Contract
- Remote
- Nursing
- RN License
- 3 years
- Health insurance
- Dental insurance
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2d

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Nurse (Clinical/Ambulatory) GS-610-11
Defense Health Agency Civilian Corps, Falls Church, VA —Huntsville, AL
Licensure: A current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of…
Up to $101,110 a year
4d
Registered Nurse - Part Time with Benefits - Weekends
Outpatient Diagnostic Center of Alabama - Madison, Athens, Decatur and Huntsville —Madison, AL
LICENSE/CERTIFICATION REQUIREMENTS: Must meet the state licensure requirement for the state in which they practice. Paid Time Off and Holiday Pay.
Quick Apply
12d

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Utilization Review Specialist - Autism
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Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…
RN Case Manager
Sheakley —Columbus, OH
A current, unrestricted Ohio state licensure or certification in a health or human services discipline that allows the professional to conduct an assessment…
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Care Manager RN

Gadsden Regional Medical Center -
Gadsden, AL

Quick Apply

Job Details

Full-time

Qualifications

RN License

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.
Identifies and appropriately refers cases to Child/Adult Protective Services, ensuring compliance with legal and ethical standards.
Provides professional 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

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 required
BCLS - Basic Life Support preferred

State Specific Requirements

Alabama: Accredited Case Manager (ACM) or Certified Case Manager (CCM) certification preferred.
New Mexico: Advanced Cardiovascular Life Support (ACLS) and Pediatric Advanced Life Support (PALS) certifications preferred.

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utilization review nurse jobs in albertville al

Care Manager RN

Registered Nurse | Review Analyst I | Remote | Detroit, MI | Contract

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