Utilization Review Nurse - LPN (Remote) Job at Morgan Stephens, Remote

RmJHYkR3Q0JKR2dWdzJMenlJVytlWFpqRGc9PQ==
  • Morgan Stephens
  • Remote

Job Description

Job Summary:

As a Utilization Management Nurse, you'll play a crucial role in our multidisciplinary team, ensuring that patients progress seamlessly through their care journey according to appropriate admission statuses. Proficient in Utilization Review processes, you'll maintain effective procedures to meet regulatory and reimbursement requirements for various payers, both commercial and government.

100% Remote - However, Only candidates on EST Time Zone are considered. 

Key Responsibilities:

  • Conduct concurrent and continued stay Utilization Management reviews, ensuring accurate data tracking, evaluation, and reporting.
  • Lead or participate actively in process improvement initiatives, collaborating with various departments and multi-disciplinary teams.
  • Efficiently manage a diverse workload in a fast-paced, ever-evolving regulatory environment.
  • Foster positive collaboration with the Care team to facilitate timely patient progression during their stay.

Job Requirements:

  • Current PN Nurse license
  • Associate's degree preferred.
  • 2 years of Utilization Management experience in large health organization.
  • Hospital case management experience is advantageous.
  • Proficiency in federal and state regulations (DOH, Medicaid/Medicare) and familiarity with third-party payers and managed care principles.

Salary Range: $75,000+
Benefits: Yes- Full benefit package available with employer contribution.

Join our dynamic team and be part of our commitment to efficient Utilization Management and patient-focused care.

​​​​​​Date of Original Job Posting: 1/25/25 

Job Tags

Similar Jobs

Bayer

Computational Biologist, Principal Scientist - CVRI Job at Bayer

 ...At Bayer were visionaries, driven to solve the worlds toughest challenges and striving for a world where 'Health for all Hunger for none is no longer a dream, but a real possibility. Were doing it with energy, curiosity and sheer dedication, always learning from unique... 

Perrigo

Process Operator - Nights Job at Perrigo

 ...Disclaimer In March of 2025, Perrigo announced that the current operations at our facility in Milton, VT will be migrated to our plant in...  ...a thorough understanding of and ability to operate all process area equipment in a safe and efficient manner, including the liquefying... 

Carenest Health Services

Registered Nurse - Medical - Surgical (Telemetry) Job at Carenest Health Services

 ...rare, it could happen. Level 1 trauma experience is preferred. If no prior travel, level 1 trauma will be required. Must be separated from BILH for a min of 6 months to be considered (perm, per diem, contract). Our interview services team will CALL for IVS review prior to... 

Optimum Staffing Inc.

Class B Truck Driver Job at Optimum Staffing Inc.

 ...7:00 AM average shift length around 9 hours Operate a Straight Truck/Box Truck Delivering building materials within a 150-mile...  ...Apply or Call Now! Recruiter: (***) ***-**** ext. 311 Driver & Operations Coordinator (***) ***-**** Weekend Callers;... 

Oak Ridge National Laboratory

Nuclear Mechanical Engineer Job at Oak Ridge National Laboratory

 ...Requisition Id15803 Overview: We are seeking a Nuclear Mechanical Engineer to join the Systems Engineering (SE) Group within the Research Reactors Division (RRD) at Oak Ridge National Lab (ORNL).Our groupis responsible forthe High Flux Isotope Reactor...