Top 17 Utilization review nurse Jobs in Milwaukee Wi

Case Mgmt Care Coord Assoc
Children's Wisconsin —Milwaukee, WI
- Weekends as needed
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
Integrated Case Manager
Children's Wisconsin —Milwaukee, WI
- Part-time
- Acute care
- Microsoft Word
- Nursing
Registerd Nurse (RN) Care Manager
Advocate Aurora Health —Milwaukee, WI
- $38.20 - $57.30 an hour
- 12 hour shift
- Nursing
- RN License
- Inpatient
RN Field Case Manager I
CorVel Corporation —Waukesha, WI
- $62,306 - $93,123 a year
- Full-time
- Nursing
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
Visit RN - Weekend Program - ProHealth Home Care and Home Hospice - .9 Fri Sat Sun
ProHealth Care —Waukesha, WI
- 12 hour shift
- CPR Certification
- Nursing
- Clean driving record
9d
Prenatal Care Coordination (PNCC) Nurse Manager.
Blessed + Beautiful Beginnings —Milwaukee, WI
- $26.81 - $50.00 an hour
- Part-time
- Anatomy knowledge
- HIPAA
- Pediatrics
- Employee assistance program
- Professional development assistance
Quick Apply
Registered Nurse Clinical Manager
Centerwell —West Allis, WI
- $77,200 - $106,200 a year
- Full-time
- CPR Certification
- Nursing
- RN License
- Paid parental leave
- Paid holidays
Visit RN - Weekend Program .45 FTE - ProHealth Home Care and Home Hospice- Benefits Eligible
ProHealth Care —Waukesha, WI
- 12 hour shift
- CPR Certification
- Nursing
- Clean driving record
Visit RN - Weekend Program - ProHealth Home Care and Home Hospice- Benefits Eligible
ProHealth Care —Waukesha, WI
- 12 hour shift
- CPR Certification
- Nursing
- Clean driving record
Utilization Review Coordinator
Lakeview Health —United States
- Full-time
- Remote
- Mid-level
- Bachelor's degree
- Case management
- Loan repayment program
- Health insurance
5d

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Utilization Review Specialist-Remote
Wellbrook Recovery —Brookfield, WI
Background or experience in social work, counseling, or behavioral health is preferred. Experience in utilization review or case management for behavioral…
Quick Apply
Behavioral Health Patient Insurance Verifier (Oconomowoc, WI Only)
Rogers Memorial Hospital, Inc. —Oconomowoc, WI
Candidates must live within driving distance of Oconomowoc, WI . The Benefit Verification Specialist I plays a key role in ensuring that front-end teams…
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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…
4d
Nurse - Skilled/Purchased Care Coordinator
US Veterans Health Administration —Columbus, OH
Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the…
$70,726 - $148,921 a year
9d

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Case Mgmt Care Coord Assoc

Children's Wisconsin -
Milwaukee, WI

Apply Now

Job Details

Full-time

Qualifications

Bachelor's degree
Hospital experience

Full Job Description

At Children’s Wisconsin, we believe kids deserve the best.

Children’s Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country.

We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today.

Please follow this link for a closer look at what it’s like to work at Children’s Wisconsin: https://www.instagram.com/lifeatcw/

Job Summary:
Coordinates transitional care and discharge planning for hospitalized children/families throughout the hospitalization and through discharge follow-up. Responsible for effective coordination of care, this role collaborates with all care team members to assure patient's care plan advocates for a safe and effective discharge plan.

Essential Functions:

Identifies and maintains an awareness of appropriate medical resources that provide additional support and assistance to patients and their families during and after hospital admission.
Provides initial ongoing assessment of the patient’s clinical situation and inclusive of their physical and behavioral needs.
Documents interventions according to department and organizational standards.
Provides daily hand off report in the electronic medical record for peer follow-up/coverage. Facilitates informed of care transitions within hospital and at time of discharge
Assumes the assigned care coordination responsibilities delegated by the RN Case Manager and/or the Care Coordinator.
Maintains knowledge base in relative fiscal influences on discharge planning including health insurance plans and Medicaid, Medicare, and Tricare
Develops, utilizes and maintains community/state resource files and protocols for referring patients/families to sources of home health care and supplies as prescribed by patient care needs and third party payers.
Provides or arranges outreach calls or visits to patients to insure appropriate delivery and access to aftercare services. Provide education to families about outpatient/observation level of care and potential co pays.
Identifies and monitors patients with long lengths of stay, rural service areas, concurrent denials, other reimbursement risks and/or placement concerns. Works with care team to resolve issues.
Prepares monthly, quarterly, and annual department reports via collaboration with the department manager. Responsible for upkeep of HCM departmental Web site on CHHS Intranet. Supports the Private Duty Nursing (PDN) Web site workflow.

Legacy Essential Functions:

Participates in the orientation of new staff and/or education of case management assistants, administrative assistant, and utilization management assistant.
Assists with My Chart referrals. Including initial setup within the electronic health record and information sharing about access of patient’s medical record with patients and familiar
Cross trained in the functions of the case management assistant and utilization management assistant role.

Education:

Bachelor's Degree required

Experience:

1+ years experience in a hospital based setting required
experience as a Case Management assistant or experience in inpatient pediatrics, discharge planning, home care, and/or other care of the child/family preferred

Knowledge, Skills and Abilities:

Independent judgment, analytical ability, systems thinking and interpersonal communications to work effectively in complex systems.
Computer knowledge and skills in WORD, Outlook, and Internet use. Advanced excel skills preferred.
An understanding of the impact of healthcare delivery systems on the patient and family.
.This is a fast paced work environment in the hospital setting
This position has some holiday and weekend requirements.

Licenses and Certifications:

ANCC-Nursing Case Management Certification - American Nurses Credentialing Center preferred

Patient Care Responsibility:

Provides care appropriate to patient population and as described in applicable policies and procedures.

Required for All Jobs:

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that may be requested in the performance of this job.
Employment is at-will. This document does not create an employment contract, implied or otherwise.

Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.

Certifications/Licenses:

ANCC-Nursing Case Management Certification - American Nurses Credentialing Center, License Social Worker (120) - State of Wisconsin

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Refine Your Search

utilization review nurse jobs in milwaukee wi

Case Mgmt Care Coord Assoc

Integrated Case Manager

Registerd Nurse (RN) Care Manager

RN Field Case Manager I

Visit RN - Weekend Program - ProHealth Home Care and Home Hospice - .9 Fri Sat Sun

Prenatal Care Coordination (PNCC) Nurse Manager.

Registered Nurse Clinical Manager

Visit RN - Weekend Program .45 FTE - ProHealth Home Care and Home Hospice- Benefits Eligible

Visit RN - Weekend Program - ProHealth Home Care and Home Hospice- Benefits Eligible

Utilization Review Coordinator

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