You haven't searched anything yet.
ABOUT US:
Hines is a nationwide, independent leader in personalized managed health care, focused on what's important to you—comprehensive 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:
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.
*****This is a Monday through Friday position, 9:30 AM to 6:00 PM.******
RESPONSIBILITIES AND PERFORMANCE :
COMMUNICATION:
PERSONAL AND PROFESSIONAL:
PM21
Requirements:QUALIFICATIONS:
PI10c110cabb51-31181-34548457
Full Time
$74k-94k (estimate)
06/11/2024
06/27/2024
hinesassoc.com
DECATUR, GA
25 - 50
1987
Private
TERRA T DARRISAW
$5M - $10M
Business Services
The following is the career advancement route for Utilization Review RN positions, which can be used as a reference in future career path planning. As an Utilization Review RN, it can be promoted into senior positions as a Clinical Outcomes Manager that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Utilization Review RN. You can explore the career advancement for an Utilization Review RN below and select your interested title to get hiring information.