Top 9 Utilization review nurse Jobs in Omaha, Ne

Utilization Review Nurse
Berkshire Hathaway Homestate Companies —Omaha, NE
- Full-time
- Hybrid work
- Nursing
- RN License
- 5 years
- Free parking
- AD&D insurance
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Registered Nurse
NOVA TC —Omaha, NE
- Full-time
- Nursing
- Psychiatry
- Addiction Medicine
- 401(k)
- Paid time off
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RN Care Manager - Omaha Market
ArchWell Health —Omaha, NE
- Full-time
- Nursing
- RN License
- Mid-level
6d
Home Health Clinical Manager
Centerwell —Omaha, NE
- $69,500 - $95,600 a year
- Full-time
- CPR Certification
- Nursing
- RN License
- Paid parental leave
- Paid holidays
Registered Home Healthcare and Hospice Nurse
Prime Home Care, LLC —La Vista, NE
- $35 - $44 an hour
- Full-time
- Nursing
- RN License
- HIPAA
- Health insurance
- Dental insurance
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Registered Nurse / RN, $10,000 Bonus Package, Home Health
AccentCare, Inc. —Omaha, NE
Graduate from an approved school of professional nursing and currently licensed to practice as a registered nurse in the state of agency operation.
$79,000 - $87,000 a year
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11d
RN - Weekend Warrior
Immanuel —Omaha, NE
Current Registered Nurse (RN) license in the respective state in which he/she is employed is required. This position offers competitive pay—up to $47.28/hour,…
Up to $47.28 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…
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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utilization review nurse jobs near omaha, ne

Utilization Review Nurse

Berkshire Hathaway Homestate Companies -
Omaha, NE

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Job Details

Permanent | Full-time

Benefits

Free parking
AD&D insurance
Paid holidays
Disability insurance
Health insurance
On-site gym
Dental insurance
Tuition reimbursement
Paid time off
Work from home
Employee assistance program
Vision insurance
Referral program

Qualifications

RN License
Employee relationship building
Medical treatment knowledge

Full Job Description

WHAT WE'RE LOOKING FOR

We have openings in our Omaha, Nebraska office for Utilization Review Nurses. The Utilization Review Nurse ensures all aspects of an injured worker’s treatment are effective, efficient, and in accordance with applicable legal requirements.

This is a full-time, permanent position within our Medical Management team and that will allow experienced nurses to put their years of clinical knowledge to use in an office environment and learn new skills in this growing industry. No UR experience required!

ESSENTIAL RESPONSIBILITIES

Review complex workers compensation medical treatment requests to ensure accordance with evidence-based medical treatment guidelines, which are generally recognized by the national medical community and are scientifically based.
Research claim file in relation to the requested medical treatment while interpreting medical reports/claims summaries and applies appropriate established guidelines to requested treatment. Refers treatment requests, which do not meet guidelines, for peer review and determination.
Advocate for the injured worker and claims department, ensuring proposed treatment requests are appropriate for the diagnosis.
Performs daily tasks within the appropriate established workflow processes, utilizes accepted guidelines and meets legislative and departmental timeframes.
Maintain patient confidentiality in discussions of treatment, disease process and conditions.
Routinely contacts providers to clarify treatment requests, examination findings, as well as obtain additional medical information as needed.
Maintains clear, concise, and accurate documentation of requested medical treatments to include clinical findings, treatment guidelines, and determination.
Provide appropriate notices to providers, injured workers, claims staff, and attorneys.
Act as a medical resource in regards to utilization review to Claims Support Nurse, Bill Review, and Claims department.
Foster a positive and close working relationship with other Company staff, including the claims staff, medical bill review, claims support nurse, special investigations, legal, liens, the call center, and client services.
Communicate effectively with individuals outside the company, including clients, medical providers, and vendors.

WHAT WILL SET YOU APART

EDUCATION: Bachelor of Science Nursing degree (BSN), or Registered Nursing degree (RN) from four-year college or university, or an accredited college.
LICENSES/EXPERIENCE: A current RN license as well as 5+ years of recent, hands-on clinical experience in a Critical care unit such as Medical Surgery, Emergency Room, ICU, Oncology, Orthopedics, Neuro or other similar settings. Must have an active state license and eligible to obtain additional state licenses.
TECHNICAL SKILLS: Knowledge of current recognized evidence-based medicine guidelines required. Proficient in Microsoft Office suite of applications. Able to perform independent internet medical research. Able to quickly master proprietary and vendor software applications.
LANGUAGE ABILITY: Able to read, analyze, and interpret common scientific and technical journals, statutes, regulations, medical reports, medical coding, medical bills, financial reports, and legal documents. Able to respond to technical inquiries or complaints from Company employees, external sources, and regulatory or auditing entities.
REASONING ABILITY: Able to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Able to deal with problems involving several concrete variables in standardized situations.

WHAT WE OFFER

Work From Home (Up to 2 days per week upon eligibility)
Onsite Gym
Garage Parking
Within walking distance of the Old Market District
Paid Time Off
Paid Holidays
Retirements Savings Match
Group Health Insurance (Medical, Dental, and Vision)
Life and AD&D Insurance
Long Term Disability Insurance
Paid Community Volunteer Day
Employee Assistance Program
Tuition Reimbursement Program
Employee Referral Program
Diversity, Equity and Inclusion Program

ABOUT US

With more than 50 years in business, Berkshire Hathaway Homestate Companies (BHHC) has grown from a regional organization to a national insurance group, offering insurance products from coast to coast. Relationships are the cornerstone of our culture, and we believe in doing the right thing. That means we invest in our business in every way possible to deliver on our mission and demonstrate that people are what powers our success. Our commitment to financial strength and integrity means our customers can rest assured that we will be there when it counts.

At BHHC we embrace diversity and foster an environment where our people can be their authentic selves. Our differences make us stronger and better together, which fosters a harmonious workplace—something we truly value. We’ve created an approachable and collaborative atmosphere. Here you’ll find a welcoming workplace where everyone can feel valued, supported, and inspired to do great work. Together, we raise the bar by being curious, remaining customer-focused, and operating with integrity.

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utilization review nurse jobs in omaha, ne

Utilization Review Nurse

Registered Nurse

RN Care Manager - Omaha Market

Home Health Clinical Manager

Registered Home Healthcare and Hospice Nurse

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ESSENTIAL RESPONSIBILITIES

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WHAT WE OFFER

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