Top 8 Utilization management nurse Jobs in Arab, Al

CASE MANAGER FT
CULLMAN REGIONAL —Cullman, AL
- Full-time
- Microsoft Word
- Nursing
- Microsoft Excel
Registered Nurse (RN) Nights
Unity Huntsville —Huntsville, AL
- Overtime
- Microsoft Word
- CPR Certification
- Nursing
Quick Apply
Registered Nurse - Home Health
Optum —Cullman, AL
- $48.97 - $58.76 an hour
- Full-time
- CPR Certification
- Nursing
- RN License
Quick Apply
1d

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Utilization Review Technician
Riverview Regional Medical Center —Gadsden, AL
Coordinate phone calls, data entry, and tracking related to authorizations, expedited reviews, appeals, and denials. High School Diploma or equivalent.
2d
RN Charge Behavioral Health
Gadsden Regional Medical Center —Gadsden, AL
Oversees the assessment, planning, implementation, and evaluation of patient care, ensuring patient care plans are followed and adjusted as needed.
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Registered Nurse (RN) - Inpatient Surgery - Springfield Regional Medical Center
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Valid nursing license from the state of practice (required). Nursing judgment and skill based on principles of the biological, physical, behavioral, and social…
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Mount Carmel —Dublin, OH
Current license to practice as registered nurse in the State of Ohio. We do not discriminate on the basis of race, gender, religion, physical disability or any…

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utilization management nurse jobs near arab, al

CASE MANAGER FT

CULLMAN REGIONAL -
Cullman, AL

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Job Details

Full-time

Qualifications

Microsoft Word
Customer communication
Microsoft Excel
Medicare
Word embeddings
Cerner
Acute care facility experience
InterQual
Utilization management
Resource utilization in healthcare

Full Job Description

Job Summary:

Coordinate with physicians, nurses, social workers and other health team members to expedite medically appropriate, cost-effective care.
Support physician provision of patient care with accountability for designated patient case load.
Facilitate precertification and payor authorization processes and facilitate collaborative management of patient care across the continuum, intervening as necessary.
Promote effective utilization and monitoring of healthcare resources and assumes a leadership role with the multidisciplinary team to achieve optimal clinical and resource outcomes.
Apply process improvement methodologies in evaluating outcomes of care.
Maintain and ensure adherence to clinical guidelines, tools and protocols based on evidence-based medicine related to quality measure indicators.
Assume leadership role in coordinating quality improvement activities related to quality measure initiatives.
Demonstrate and encourage team behavior and exceptional patient/guest experiences.
Uphold and promote patient safety and quality.

Education:
Associate's degree in nursing or higher degree is required. Currently licensed by the state of Alabama. BSN preferred.

Experience:
Five years' clinical experience in acute care setting i.e., medical surgery critical care, ER, OR required.

One year experience in Utilization Review with JIVA, Interqual, Cerner, Medicare, HMOs, and other payors.

Additional Skills/Abilities:
Skill and proficiency in applying highly technical principles, concepts and techniques that are central to case management. Advanced communication and interpersonal skills with all levels of internal and external customers. Must be proficient in Microsoft Word and Excel. Excellent organizational skills are required. Must be able to set priorities appropriately and handle multiple issues concurrently.

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utilization management nurse jobs in arab, al

CASE MANAGER FT

Registered Nurse (RN) Nights

Registered Nurse - Home Health

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