Location: Fully remote (PA RN License or Compact including PA Required), Must Reside in PA, NJ, or DE Employment type: Contract to full-time hire Position Overview: We are seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)to join our team. This position is ideal for an RN with prior work in insurance utilization review. Key Responsibilities: Conduct clinical reviews to determine medical necessity and appropriateness of care Apply evidence-based criteria to assess patient treatment plans and services Collaborate with healthcare providers and insurance partners to ensure efficient, quality patient care Document review findings accurately and in a timely manner Maintain compliance with internal and external regulatory standards Required Qualifications: Active and unrestricted PA RN license (or Compact license including PA) 2-5+ years ofprior experience in insurance utilization review Strong clinical judgment and knowledge of hospital workflows Proficient in using clinical review tools and electronic health records Familiarity with InterQual or Milliman criteria. #J-18808-Ljbffr
...Join Our Award-Winning Team as a Part-Time Registered Nurse (RN) We are currently hiring a Part-Time Registered Nurse to support our Ontario assistive home care branch! If you're seeking a nursing position that allows you to step away from bedside care, create your...
...Role Overview: We are seeking a Technical Recruiter to support hiring across our engineering organization, spanning software and hardware... ...for roles within satcom, telecom, aerospace, or adjacent deep-tech domains, translating highly technical requirements into...
Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation...
Delta Companies seeks a Nocturnist to provide high-quality inpatient care during overnight shifts. In this hospitalist role, you will manage admissions, cross-cover existing patients, respond to rapid responses and codes, and coordinate care with nursing, specialists, and...
Human Resources Assistant (Part-Time) Department: Human Resources Reports To: Chief People Officer Status: Part-Time (20 hours per week) FLSA Status: Non-Exempt About Us At SPAN, Inc. / Meals on Wheels of Denton County, our people are our greatest ...