Utilization Review Nurse | Up to $63/hr + Pension Benefits Job at Lancesoft INC, Las Vegas, NV

  • Lancesoft INC
  • Las Vegas, NV

Job Description

Job Description

Job Description

Title: Utilization Review Nurse (RN)
Department: Case Management
Job Type: Full-Time

Facility Details

  • Academic Medical Center
  • Nevada’s:
    • Level I Trauma Center
    • Verified Burn Center
    • Transplant Center
  • First & only Magnet®-Recognized hospital in Nevada
  • Major tertiary care hospital serving Southern Nevada

Pay & Benefits

  • Hourly Pay: $40 – $63/hour
  • Employer-paid Nevada PERS pension
  • Competitive health & retirement benefits
  • No state income tax in Nevada

Position Summary

The Utilization Review Nurse evaluates patient admissions and hospital stays to ensure:

  • Medical necessity
  • Appropriate level of care
  • Efficient resource utilization
  • Compliance with insurance/payer requirements

Main duties:

  • Review medical records/charts
  • Apply InterQual & Milliman criteria
  • Coordinate with physicians/case managers
  • Ensure accurate documentation
  • Support discharge planning and utilization management
  • Verify compliance with Medicare/Medicaid guidelines

Requirements

Education

  • Graduate of accredited nursing school

Experience

Required:

  • 5 years acute-care clinical RN experience
  • Minimum 1 year in:
    • Utilization Management
    • Case Management
    • Clinical Documentation Improvement (CDI)
  • 3+ years Utilization Management experience
  • 3+ years discharge planning experience in acute care
  • Experience with:
    • InterQual
    • Milliman guidelines

Must be able to pass InterQual exam.

License & Certifications

Required:

  • Active Nevada RN license

~SK

\nCompany Description

LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.

Company Description

LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.

Job Tags

Hourly pay, Full time

Similar Jobs

New York State Office of Mental Health

Psychiatrist Job at New York State Office of Mental Health

 ...County. PPC has a recovery-oriented treatment philosophy and provides a wide array of services including behavioral modalities, animal assisted therapy, and ECT. PPC is affiliated with several academic institutions and provides clinical training to Psychiatric Residents and... 

RR Contracting LLC

Assistant Construction Lead Job at RR Contracting LLC

 ...RR Contracting LLC Assistant Construction Lead Full-Time | In Person | Lebanon, MO 65536 To Serve, Not To Be Served...  ...outside the area may be required with advance notice Company Summary RR Contracting LLC is a construction company built... 

National Positions

Senior Ecommerce Sales Executive | Digital Marketing & Growth Solutions Job at National Positions

 ...Positions National Positions is an award winning, boutique digital marketing agency with 22 years of experience helping businesses grow...  ...measurable results. About the Role We are hiring an experienced sales professional who knows how to close business. This is a... 

Colab

Social Media & Content Specialist | Part-Time & Remote Job at Colab

 ...Key Responsibilities Develop and execute social media strategies for client accounts. Plan, shoot, and edit short-form video content for social media platforms. Create engaging Reels, TikToks, and other video content. Develop content ideas based on client goals... 

Eximia Research

Site Manager Job at Eximia Research

 ...Site Manager Eximia Clinical Research | Job Description Location: Des Moines, Iowa Reports to: Regional Director of Operations Position Summary The Site Manager leads the day to day operations of an Eximia clinical research site. This role translates study...