Utilization Review RN
Hines and Associates IncFreeport, IL, United Statesjob_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_descriptionThis is a Monday through Friday position, 9 : 30 AM to 6 : 00 PM. Completes first level reviews within the scope of practice relevant to the clinical area(s) addressed in the initial clinical review. General Medical-Surgical nursing is sufficient to be relevant to the clinical areas addressed in most initial clinical reviews. . Demonstrates ability to assess a patients current medical status, including complications and untoward events, which may require additional intervention. Provides certification of medical, disability and workers compensation cases. Demonstrates a thorough understanding of criteria sets and their limitations including when a second level review is required. Evaluates appropriateness of current plan of care. Assesses aftercare needs, implements discharge planning and / or case management referral in a timely manner. Maintains knowledge of current advances and trends in medical care. Demonstrates knowledge of URAC guidelines, Hines policies and procedures, and standards of practice and their revisions. Able to attain and maintain the minimal quality assurance performance standards. Demonstrates assertiveness in completion of precertification and concurrent review within the guidelines of URAC, disability, workers compensation regulations, and state and federal requirements and according to the Hines policies and procedures. Performs onsite evaluations as needed or requested. Additional responsibilities as assigned. Communicates with hospital staff, physicians, other providers and Hines customer contacts in a competent, calm, effective and professional manner. Effectively communicates the need to refer to a higher-level review for questionable plans of treatment. Provides written documentation concerning the clinical information obtained regarding the patients status, benefit and claim concerns, and validation of criteria. Communicates knowledge of policies and procedures, URAC guidelines, disability and workers compensation regulations, state and federal requirements, and standards of practice. Participates in self-evaluation by identifying areas of strength and limitations and offers and accepts constructive criticism. Creative and assertive. All First Level Reviewers are required to sign and honor a confidentiality statement at the time of hire and annually at the time of performance reviews. Registered Nurse with valid, unrestricted, current nursing license in the state or territory of the United States where employed. For mental health / substance abuse, licensed medical professional with an unrestricted license in the state or in a state that has licensure reciprocation with the state of the office location the employee is working in may perform first level reviews. Accepted licensure includes but is not limited to RN, LMSW, LMHC. Successful completion of UR nurse orientation program. Minimum of 3 years recent acute clinical practice required, 5 years preferred. Managed care, disability or workers compensation experience helpful but not mandatory. Customer service oriented. Hines welcomes diversity and as an equal opportunity employer all qualified applicants will be considered regardless of race, religion, color, national origin, sex, age, sexual orientation, gender identity, disability or protected veteran status.
Description :
Nurses are you looking for a change? Want to work no nights, no weekends, and no holidays? Be able to work from home 50% of the time once trained? Check out Hines & Associates!
ABOUT US :
Hines is a nationwide, independent leader in personalized managed health care, focused on whats important to youcomprehensive services with the program excellence and cost containment that you demand. Hines & Associates, Inc.s reputation as an industry leader is founded on over three decades of innovative and professional health care excellence. Serving all aspects of the industry, Hines is committed to conserving health care dollars while ensuring quality care through effective programs and personalized service.
WHAT WE OFFER :
- Competitive salary and benefits, including medical, dental, vision, long-term care, short-term disability, long-term disability, company paid and voluntary life insurance. Critical Illness, accident insurance and flexible spending also available!
- 401k plan with company match, fully vested after 1 year.
- No weekends and nights!
- Paid Holidays
- Work-life balance.
- Remote / hybrid setting (once trained)
ROLE DESCRIPTION :
This individual will utilize clinical knowledge and communication skills to obtain patient specific information regarding patient condition and proposed treatments and procedures to determine if illness and / or proposed services meet acceptable criteria sets and acceptable nursing practice guidelines for outpatient treatment or inpatient confinement. This individual will certify treatment for confinement when criteria and / or practice guidelines are met, in accordance with the health benefit plan, disability, workers compensation regulations and state and federal regulations. If these conditions do not appear to be met, this individual will defer decision to a second level reviewer. This individual interfaces with case managers and disease management nurses on active cases involved in other Hines programs.
RESPONSIBILITIES AND PERFORMANCE :
COMMUNICATION :
PERSONAL AND PROFESSIONAL :
PM21
Requirements : QUALIFICATIONS :
Compensation details : 57244-62180 Yearly Salary
PIb2a7cfb55c01-29952-37242209
serp_jobs.job_alerts.create_a_job
Rn Utilization Review • Freeport, IL, United States
Job_description.internal_linking.related_jobs
Nurses – are you looking for a change? Want to work no nights, no weekends, and no holidays? Be able to work from home 50% of the time once trained? Check out Hines & Associates!.Hines is a nationw...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
Atlas MedStaff is seeking an experienced Operating Room Registered Nurse for an exciting Travel Nursing job in Freeport, IL.
Shift : 4x10 hr days Start Date : ASAP Duration : 13 weeks Pay : $2341.Atlas ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
TravelNurseSource is working with AMN Healthcare to find a qualified OR RN in FREEPORT, Illinois, 61032!.Job Description & Requirements.
Registered Nurse – Perioperative Nurse - Operating Room ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days TravelNurseSource is working with Fusion Medical Staffing to find a qualified OR RN in Freeport, Illinois, 61032!.Facility in Freeport, Illinois.
Fusion Medical Staffing is seeking a skilled Operati...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 
To be eligible to enlist in the U.Navy, candidates must be between the ages of 18-34.Americans live for fireworks on the Fourth of July.
The other 364 days of the year, Explosive Ordnance Disposal (...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Nurses – are you looking for a change? Want to work no nights, no weekends, and no holidays? Be able to work from home 50% of the time once trained? Check out Hines & Associates!.Hines is...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours TravelNurseSource is working with Core Medical Group to find a qualified Long-Term Care RN in Savanna, Illinois, 61074!.Client in IL seeking Registered Nurse : LTC / SNF.
We are looking for a healthcar...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day TravelNurseSource is working with Skyline Med Staff to find a qualified Long-Term Care RN in Savanna, Illinois, 61074!.Join the Best in Travel Nursing! Skyline Med Staff was honored as the #1 Best...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days TravelNurseSource is working with Skyline Med Staff to find a qualified Long-Term Care RN in Savanna, Illinois, 61074!.Join the Best in Travel Nursing! Skyline Med Staff was honored as the #1 Best...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days TravelNurseSource is working with MUVE Healthcare LLC to find a qualified OR RN in Winnebago, Illinois, 61104!.Join our team for an exciting travel nursing opportunity!.
As a member of the interdisc...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 
Flexible Full-Time, Part-Time, or PRN.Are you a night owl who thrives in calm, focused environments?.Southern Health Partners (SHP).
For over 30 years, we’ve supported nurses with.Choose shifts that...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day TravelNurseSource is working with AHS Staffing to find a qualified Long-Term Care RN in Savanna, Illinois, 61074!.AHS NurseStat is looking for a LTC Registered Nurse in Savanna, IL for a Long Term ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 
Fusion Medical Staffing is seeking an experienced Operating Room Registered Nurse for an exciting Travel Nursing job in Freeport, IL.
Shift : Inquire Start Date : ASAP Duration : 13 weeks Pay : $2336 / ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days TravelNurseSource is working with Fusion Medical Staffing to find a qualified OR RN in Freeport, Illinois, 61032!.Facility in Freeport, Illinois.
Fusion Medical Staffing is seeking a skilled Operati...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 
Founded in 1979, we were the first hospice agency in our region and one of the first 50 hospice agencies in the nation.We are looking for exceptional people to join our exceptional team.People who ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days TravelNurseSource is working with MUVE Healthcare LLC to find a qualified ICU / Critical Care RN in Winnebago, Illinois, 61104!.
Join our team for an exciting travel nursing opportunity!.As a member o...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 
LocumJobsOnline is working with CompHealth to find a qualified Anesthesiology CRNA in Dixon, Illinois, 61081!.A strong CRNA team is seeking a permanent CRNA to join their welcoming community.This p...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days TravelNurseSource is working with Core Medical Group to find a qualified Long-Term Care RN in Savanna, Illinois, 61074!.Client in IL seeking Registered Nurse : LTC / SNF.
We are looking for a healthcar...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
- serp_jobs.job_card.promoted
Utilization Review RN
Hines & Associates Inc Careersfreeport, Illinois, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Travel Nurse - RN - OR - Operating Room - $2341.6 / Week
Atlas MedStaffFreeport, IL, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Travel Nurse RN - OR - $2,199 to $2,423 per week in Freeport, IL
TravelNurseSourceFREEPORT, IL, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Travel Registered Nurse - OR - $2,196 to $2,336 per week in Freeport, IL
TravelNurseSourceFreeport, IL, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Bomb Technical
U.S. NavyArgo Fay, IL, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Utilization Review RN
Hines & Associates IncFreeport, IL, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Travel Nurse RN - Long-Term Care - $1,660 per week in Savanna, IL
TravelNurseSourceSavanna, IL, USserp_jobs.job_card.full_time +1
- serp_jobs.job_card.promoted
Travel Nurse RN - Long-Term Care - $1,852 per week in Savanna, IL
TravelNurseSourceSavanna, IL, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Travel Registered Nurse - Long-Term Care - $1,852 per week in Savanna, IL
TravelNurseSourceSavanna, IL, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Travel Nurse RN - OR - $2,989 to $3,060 per week in Winnebago, IL
TravelNurseSourceWinnebago, IL, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Night Nurse Opening – $37+ / hr, Shift Differential, and Flexible Hours
Southern Health PartnersFootville, WI, United Statesserp_jobs.job_card.full_time +1
- serp_jobs.job_card.promoted
Travel Registered Nurse - Long-Term Care - $1,803 per week in Savanna, IL
TravelNurseSourceSavanna, IL, USserp_jobs.job_card.full_time +1
- serp_jobs.job_card.promoted
Travel Nurse - RN - OR - Operating Room - $2336 / Week
Fusion Medical StaffingFreeport, IL, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Travel Nurse RN - OR - $2,196 to $2,336 per week in Freeport, IL
TravelNurseSourceFreeport, IL, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Hospice RN Case Manager
Northern Illinois HospiceFreeport, IL, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Travel Nurse RN - ICU / Critical Care - $2,359 to $2,415 per week in Winnebago, IL
TravelNurseSourceWinnebago, IL, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Certified Registered Nurse Anesthetist (CRNA) - Anesthesiology - General / Other - $300,000 to $305,000 per year in Dixon, IL
LocumJobsOnlineDixon, IL, USserp_jobs.job_card.full_time +2
- serp_jobs.job_card.promoted
Travel Registered Nurse - Long-Term Care - $1,660 per week in Savanna, IL
TravelNurseSourceSavanna, IL, USserp_jobs.job_card.full_time +1