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
...Job Description Licensed Practical Nurse (LPN) Pediatric Clinic Job Type: Part-Time | Day Schedule: 7:30a-5p Tuesday and Thursday (possible Mondays as well) Your experience matters Southern Tennessee Regional Health System - Lawrenceburg is part of Lifepoint...
...Airport Service Operations ManagerDallas-Fort Worth International AirportMust be able to work an overnight shift$80K to $85K Annually... ...Logistics is seeking a dynamic, hands-on Airport Service Operations Manager to work overnight at our DFW Receiving and Distribution Center,...
...verification checksScreening medical and scientific literature for safety informationPreparation of Reconciliation (weekly, monthly... ...and participate in the non-conformance/CAPA process.The Drug Safety Associate will also be assigned other duties and tasks as required...
...Come join our growing team! We are seeking energetic, highly motivated Flight Attendants who wish to join a committed group of safety and service professionals at Avelo Airlines. We are a new, high value/low fare airline that is inspiring travel throughout the communities...
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...