Top 22 Utilization review nurse Jobs in Henderson Nv

Preservice Review Nurse - Remote
UnitedHealthcare —Las Vegas, NV
- $29 - $52 an hour
- Full-time
- Remote
- Microsoft Word
- Microsoft Outlook
- RN License
1d
Utilization Review Nurse
Access Healthcare Staffing & Recruitment —Las Vegas, NV
- $40 - $63 an hour
- Weekends as needed
- Nursing
- RN License
- Office
Quick Apply
Case Manager Per Diem
Kindred Hospital Las Vegas - Sahara —Las Vegas, NV
- $47.26 - $69.12 an hour
- Per diem
- Master of Social Work
- Nursing
- RN License
- Health savings account
- Health insurance
8d
Utilization Review Nurse
Dynamic Computing Services —Las Vegas, NV
- $40 - $63 an hour
- Weekends as needed
- Nursing
- RN License
- Office
- Health savings account
- Health insurance
Per Diem Utilization Review Nurse
University Medical Center of Southern Nevada —Las Vegas, NV
- $59.13 an hour
- Weekends as needed
- Nursing
- RN License
- Office
Clinical Review Coordinator
Commence —Las Vegas, NV
- $60,000 - $83,200 a year
- Online Application
- Remote
- Nursing
- RN License
- Computer literacy
12d
RN CASE MANAGER - UTILIZATION REVIEW (FULL-TIME)
Valley Health System Consolidated Services —Las Vegas, NV
- $85,400 - $113,100 a year
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Dental insurance
Utilization Specialist
Seven Hills Hospital —Henderson, NV
- Full-time
- CPR Certification
- Nursing
- RN License
RN Case Manager - Hospital Utilization and Transitions of Care
Optum —Las Vegas, NV
- $35 - $63 an hour
- Full-time
- RN License
- Hospital
- Computer literacy
Quick Apply
RN CASE MANAGER - SPRING VALLEY (FULL-TIME)
Valley Health System Consolidated Services —Las Vegas, NV
- $83,500 - $113,100 a year
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Dental insurance
13d
Case Manager - Licensed RN
Canyon Vista Post Acute —Las Vegas, NV
- Full-time
- Nursing
- LVN
- RN License
Quick Apply
LPN Supervisor (Day/NOC Shift)
Charleston Post Acute —Las Vegas, NV
- Full-time
- Nursing
- LVN
- RN License
Quick Apply
4d
RN Case Manager
VN&Associates —Las Vegas, NV
- $40 - $63 an hour
- Full-time
- Nursing
- RN License
- BLS Certification
- Health savings account
- Disability insurance
Quick Apply
Director of Nursing - Ambulatory Surgery Center
Velazquez Pain Relief Center —Las Vegas, NV
- $110,000 - $140,000 a year
- Full-time
- Nursing
- RN License
- Outpatient experience
- Health insurance
- Dental insurance
Quick Apply
Appeals Professional III (Licensed Clinician)
Tanaq Support Services LLC —United States
- Full-time
- Remote
- Nursing
- RN License
- Writing skills
12d
Claims Nurse (Utilization Management / Claims Review) Must have CALIFORNIA license
Dragonfly Global —United States
- $100,000 - $105,000 a year
- Full-time
- Remote
- LVN
- RN License
- Mid-level
- Travel reimbursement
- Health savings account
Quick Apply

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Preservice Review Nurse - Remote
UnitedHealthcare —Las Vegas, NV
A current, unrestricted RN license for the state of Nevada. Be knowledgeable of and comply with the Nurse Practice Act for each state that licensure is required…
$29 - $52 an hour
1d
Utilization Review Nurse
Access Healthcare Staffing & Recruitment —Las Vegas, NV
Chart review and clinical documentation analysis. Graduate of an accredited nursing program. Analyzes medical records to ensure care meets established clinical…
$40 - $63 an hour
Quick Apply

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Case Manager (RN) - Full-Time
OhioHealth Rehabilitation Hospital —Columbus, OH
Current Licensure per state guidelines in clinical or related discipline OR a Bachelor's or Master's in a health or human services discipline.
$70,000 - $84,000 a year
Quick Apply
16h
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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Preservice Review Nurse - Remote

UnitedHealthcare -
Las Vegas, NV

Apply Now

Job Details

Full-time
$29 - $52 an hour
1 day ago

Qualifications

Microsoft Word
Microsoft Outlook
RN License
Word embeddings
Windows
Editing

Full Job Description

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

The Preservice Review RN is responsible for reviewing requests received from providers, using approved protocols and criteria. (Milliman Care Guidelines or Healthcare Operations Protocols). The RN is expected to approve those requests that meet medical necessity, along with benefit level, and the contractual status of the provider / facility as appropriate for self-funded lines of business. This position is also a resource to new staff and may precept as well.

*** Candidates must be available to work Monday - Friday from 8:00 am - 5:00 pm PST. ***

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

Evaluate and assess each request verifying eligibility and specific product
Determine benefit level based on site of service
Utilize written criteria to approve, pend or send the case to the medical director for review
Send cases for pending process when appropriate
Maintain at least 98% accuracy of clinical review case notes in Facets
Maintain productivity standards and maintain compliance with all regulatory agencies including NCQA, DOL, DOI for each state, Medicaid, CMS and OPM
Maintain at least 98% accuracy in summarizing cases for the Medical Director to review using appropriate protocols based members clinical and benefit information
Maintain compliance with turnaround times based on the member's product, the type of request and the specific regulatory agency
Be knowledgeable of and comply with the Nurse Practice Act for each state that licensure is required to perform SHL business
Precepts / act as a resource for new staff

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

A current, unrestricted RN license for the state of Nevada
2+ years of recent critical care, ER and/or med-surg nursing experience
Proficient with Microsoft Word to create, edit, save and send documents
Ability to navigate a Windows environment, Microsoft Outlook, and conduct Internet searches

Preferred Qualifications:

2+ years Utilization Management experience in managed care, acute or rehab setting
Knowledge of utilization review process and prior authorization process in a managed health care industry
Knowledge of ICD9 / CPT coding and Milliman Care Guidelines

Soft Skills:

Detail oriented, excellent organizational skills
Ability to work well under pressure with sound decision making ability
Excellent written and oral communication skills

All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29 - $52 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Apply Now

Refine Your Search

utilization review nurse jobs in henderson nv

Preservice Review Nurse - Remote

Utilization Review Nurse

Case Manager Per Diem

Utilization Review Nurse

Per Diem Utilization Review Nurse

Clinical Review Coordinator

RN CASE MANAGER - UTILIZATION REVIEW (FULL-TIME)

Utilization Specialist

RN Case Manager - Hospital Utilization and Transitions of Care

RN CASE MANAGER - SPRING VALLEY (FULL-TIME)

Case Manager - Licensed RN

LPN Supervisor (Day/NOC Shift)

RN Case Manager

Director of Nursing - Ambulatory Surgery Center

Appeals Professional III (Licensed Clinician)

Claims Nurse (Utilization Management / Claims Review) Must have CALIFORNIA license

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