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

WVpmeEgyY1ZSdHhwQTdJNWtCOFoyMFM2Mmc9PQ==
  • 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: $80,000+
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: 2/2/25 

Job Tags

Remote job,

Similar Jobs

Wegmans Food Markets

Cook Job at Wegmans Food Markets

Schedule: Full time Availability: Morning, Afternoon, Evening (Includes Weekends). Age Requirement: Must be 18 years or older Location: Wilmington, DE Address: 371 Buckley Mill Road Pay: $16 / hour Job Posting: 01/18/2025 Job Posting End: 02/01/2025 Job ID:R0234284 we are...

Kaleidoscope ABA

ABA Behavior Coordinator Job at Kaleidoscope ABA

 ...Kaleidoscope ABA Therapy is looking for dynamic and passionate people who want to make a difference and impact the lives of the children in our centers. We proudly boast over 24 Centers in the Northeast and counting! Join a growing team and learn from the many qualified... 

Accenture

Data Steward Job at Accenture

At Accenture Federal Services, nothing matters more than helping the US federal government make the nation stronger and safer and life better for people.?Our 13,000+ people are united in a shared purpose to pursue the limitless potential of technology and ingenuity for...

Molina Healthcare

Project Manager - Healthcare (Remote) Job at Molina Healthcare

 ...Plans and directs schedules as well as project budgets. Monitors the project from inception...  ...' primary focus is project/program management, rather than the application of expertise...  ...they may have technical team members. Healthcare Project Management experience is very important... 

Belton Regional Medical Center

New Graduate Nurse RN Residency Job at Belton Regional Medical Center

 ...Relocation Bonus offered for those more than 50 miles from our hospitals **We are FULL IN Mother Baby, Labory and Delivery, NICU and...  ...Program is a year-long program designed to give you hands-on experience to help establish valuable clinical and critical thinking skills...