Top 9 Utilization review nurse Jobs in York Pa

Care Management Nurse - ED/IP Team - Weekend Option 3
Wellspan Health —York, PA
- Part-time
- Nursing
- RN License
- 5 years
- Health savings account
- Disability insurance
Care Nurse Coordinator RN - Behavioral Health Adult Main Inpatient - Days
Wellspan Health —Mount Gretna, PA
- Part-time
- Nursing
- Psychiatry
- RN License
- Retirement plan
Case Manager/Discharge Planner- PRN
Helen M. Simpson Rehabilitation Hospital —Mechanicsburg, PA
- $40 an hour
- PRN
- Hospital
- Inpatient
- Mid-level
- Opportunities for advancement
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Case Manager - York Hospital - Part-Time
Wellspan Health —York, PA
- 8 hour shift
- Acute care
- Nursing
- RN License
- Paid parental leave
- Health insurance
11d
Nurse Case Manager
Battelle —Harrisburg, PA
- Full-time
- Hybrid work
- Nursing
- RN License
- BLS Certification
- Wellness program
- Health insurance

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Care Nurse Coordinator RN - Behavioral Health Adult Main Inpatient - Days
Wellspan Health —Mount Gretna, PA
In addition, will function as a resource for nursing staff to develop, organize and implement appropriate care and educational needs.

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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
10d

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Care Management Nurse - ED/IP Team - Weekend Option 3

Wellspan Health -
York, PA

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Job Details

Part-time

Benefits

Health savings account
Disability insurance
Health insurance
Paid time off
Retirement plan

Qualifications

RN License
BLS Certification
Associate's degree

Full Job Description

Weekend Option 3 - 50/52 weekends

Day shift: 7am-7pm

Split weekends in the ED and IP Team

General Summary

Performs a variety of duties and applies utilization and care management techniques to determine the most efficient use of resources to support the provision of appropriate, cost effective and quality health care. Works in a team type assignment or Care Coordination Team (CCT) Model (Care Manager and Social Worker teams are assigned to patients by physician practice) to address patient care transition needs. Provides leadership in the integration of utilization and care management principles throughout the hospital.

Duties and Responsibilities

Essential Functions:

Performs initial reviews for medical necessity and appropriateness of setting for the assigned case load.
Conducts concurrent reviews to ensure medical necessity for continued hospitalization and initiates problem-solving techniques as needed to prevent over and/or under utilization.
Liaisons between third party payers and the treatment team regarding the identified treatment plan in accordance with contractual guidelines or System policy.
Assists the patient care team with the identification and coordination of alternative treatment settings which will provide appropriate care, maintain quality of care and reduce cost.
Identifies conditions which require care management across the continuum. Collaborates with the members of the patient care team to identify interdisciplinary needs.
Makes arrangements for discharge needs (DME, Home Health, IV antibiotics, etc.) in collaboration with patients, families and care team as needed.
Assists with the collection and analysis of utilization patterns and denied cases.
Brings known or suspected problems of under-, over-, or inappropriate utilization of resources to the attention of the appropriate manager(s).

Common Expectations:

Prepares and maintains appropriate documentation as required.
Maintains established policies and procedures, objectives, quality assessment and safety standards.
Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Benefits Offered:

Comprehensive health benefits
Flexible spending and health savings accounts
Retirement savings plan
Paid time off (PTO)
Short-term disability
Education assistance
Financial education and support, including DailyPay
Wellness and Wellbeing programs
Caregiver support via Wellthy
Childcare referral service via Wellthy

Qualifications

Minimum Education:

Associates Degree Required

Work Experience:

5 years of RN experience required
ED experience preferred
Utilization management, care management, or clinical nursing specialty. Preferred

Licenses:

Licensed Registered Nurse Upon Hire Required or
Registered Nurse Multi State License Upon Hire Required and
Basic Life Support Upon Hire Required

Knowledge, Skills, and Abilities:

Excellent interpersonal/communication skills.

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utilization review nurse jobs in york pa

Care Management Nurse - ED/IP Team - Weekend Option 3

Care Nurse Coordinator RN - Behavioral Health Adult Main Inpatient - Days

Case Manager/Discharge Planner- PRN

Case Manager - York Hospital - Part-Time

Nurse Case Manager

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