Registered Nurse - Quality & Utilization Review Coordinator - SUNYWNYRN Job at NavitsPartners, Darien, IL

OFJhLzVEb1FVN3FOSDN0N0tWMS9YTVdLK1E9PQ==
  • NavitsPartners
  • Darien, IL

Job Description

Registered Nurse – Quality & Utilization Review Coordinator

Qualifications:

  • RN license with experience in quality assurance or utilization review.
  • Minimum of 3 years in a hospital or managed care setting.
  • Knowledge of regulatory standards, including CMS and Joint Commission guidelines.
  • Strong written and verbal communication skills.
  • Proficiency in data analysis and performance improvement strategies.

Duties:

  • Assess healthcare services for efficiency, effectiveness, and compliance.
  • Conduct retrospective and concurrent medical necessity reviews.
  • Develop and implement quality improvement initiatives.
  • Analyze trends in utilization and make recommendations for policy adjustments.
  • Work closely with case managers and providers to optimize patient outcomes.
  • Ensure adherence to accreditation and regulatory requirements.

Pay:

  • Medium weekly pay range: $2,100 - $2,600

Job Tags

Weekly pay,

Similar Jobs

F.H. Paschen

Recruiting Intern Job at F.H. Paschen

 ...Assisting with organization of recruiting documentation including applications, resumes, and interview evaluations Schedule interviews as requested by hiring managers and recruiting team Create seamless interview experience for candidates by coordinating... 

DiPasquale Moore

Spanish Bilingual Administrative Assistant / Customer Service Job at DiPasquale Moore

 ...Bilingual Administrative Assistant / Customer Service SALARY: Competitive salary commensurate with experience REQUIREMENTS: High School Diploma...  ...of 1 year customer service experience; Fluent in Spanish/English PREFERRED: Paralegal certificate or associate... 

Rivka Development

Solution Architecture - Fraud Job at Rivka Development

 ...CrossCore, FraudNet, PreciseID, Emailage, Fraud Service Orchestration, BioCatch, Lynx, Fraud Detection Hub, Early Warning Services, Twilio, Bridger, OFAC. - Restful APIs, API-led design, Event Driven Architecture - Cloud Architecture & Security AWS (must have),... 

Frontier Senior Living

Dietary Aide Job at Frontier Senior Living

 ...light, bright, and beautiful Assisted Living and Memory Care communities - where our residents are #1 and our team members shine! Dietary Aide Frontier Senior Living is seeking an outstanding Dietary Aide to join Heartis Longview community located in Longview, Texas.... 

The Call Firm, LLC

QA Tester Job at The Call Firm, LLC

We are seeking a detail-oriented and analytical QA Tester to join our team. As a QA Tester, you will be responsible for ensuring the quality and reliability of our software products by identifying bugs, conducting tests, and improving overall user experience. If you have...