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Utilization review nurse jobs in Jackson, MS

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  • Registered Nurse (RN) - Head Nurse - Operating Room (OR)

    Baptist Memorial Health 4.7company rating

    Utilization review nurse job in Jackson, MS

    The Head Nurse is responsible for overseeing patient care, staff management and day to day operations of a specific department or nursing unit. Coordinates and provides care utilizing the critical thinking framework known as the nursing process. The nursing process forms the foundation of the nurse's decision making to help partner with patients/families to attain, maintain and restore health whenever possible. Blends caring, compassion, knowledge and integrity to provide safe quality care that preserves patient autonomy, dignity and rights. Assists manager by providing clinical leadership for nursing employees on an assigned unit to maintain continuity of nursing care in conjunction with the hospital/nursing mission, goals, policies and procedures. Works in collaboration with the Manager/Director/CNO to ensure goal attainment.system standard jd Responsibilities Interpret, review, and combine diagnostic data relevant to the patient's current condition. Collaborates with nursing leadership and other disciplines to identify opportunities for department improvements and drive change. Intervenes and provides guidance and direction during life threatening situations. Evaluates the effectiveness of interventions and expected outcomes. Implements innovative works processes that improve patient outcomes. Participates in clinical leadership activities such as coaching, counseling, mentoring, hiring, firing, yearly performance evaluations, staffing, payroll, and productivity. Participates in activities designed to improve health care delivery. Communicates/collaborates with others in providing patient care. Supports life-long learning. Completes other duties as assigned. Requirements, Preferences and Experience Experience Minimum : Minimum of 2 years experience on current unit or in like setting/specialty area. Licensure, Registration, Certification Preferred : ACLS Minimum : RN; BLS CERTIFICATION WITHIN 14 DAYS OF HIRE Special Skills Minimum : Computer literacy About Baptist Memorial Health Care At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey. At Baptist, We Offer: Competitive salaries Paid vacation/time off Continuing education opportunities Generous retirement plan Health insurance, including dental and vision Sick leave Service awards Free parking Short-term disability Life insurance Health care and dependent care spending accounts Education assistance/continuing education Employee referral program Job Summary: Position: 11965 - RN-Head Nurse Facility: MBMC - Hospital Department: JS OR MBMC Category: Nurse RN Type: Clinical Nurse Work Type: Full Time Work Schedule: Days Location: US:MS:Jackson Located in the Jackson, MS metro area
    $55k-99k yearly est. 5d ago
  • Clinical Reviewer, Nurse

    Evolent 4.6company rating

    Utilization review nurse job in Jackson, MS

    **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** Job Description As a Clinical Reviewer, Nurse, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical environment. You can enjoy better work- life balance on a team that values collaboration and continuous learning while providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer, Nurse, you will routinely interact with leadership and management staff, other CR's (Clinical Reviewers), providers, office staff and Field Medical Directors (FMDs). **What You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not pass the authorization approval process at first call while promoting a supportive team approach with call center staff. Clinical reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical record documentation in order to approve services that meet clinical review criteria. + Conducts ongoing activities which monitor established quality of care standards in the participating provider network and for other clinical staff. + Converses with medical office staff to obtain additional pertinent clinical history/information; notifies of approvals and denials, giving clinical rationale, while providing optimum customer service through professional/accurate communication and maintaining NCQA and health plans required timeframes. + Documents all communication with medical office staff and/or treating provider. + Practices and maintains the principles of utilization management by adhering to policies and procedures. + Participates in on-going training programs to ensure quality performance in compliance with applicable standards and regulations, as well as, being audited to ensure guidelines are applied appropriately. **Qualifications Required and Preferred:** + Current, unrestricted state licensure as a Registered Nurse- **Required** + Associate or Bachelors in Nursing (Must be a Registered Nurse) - **Required** + You must be able to work a minimum of 30 hours/week- **Required** + Strong interpersonal and communication skills - **Required** + Proficient computer skills; must be able to talk and type simultaneously- **Required** + 5+ years clinical experience- **Preferred** To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **Technical Requirements:** We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. **Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.** **If you need reasonable accommodation to access the information provided on this website, please contact** ************************** **for further assistance.** The expected base salary/wage range for this position is $34-$37/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
    $34-37 hourly 3d ago
  • Utilization Management Nurse

    Centerwell

    Utilization review nurse job in Jackson, MS

    **Become a part of our caring community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent service to others. **Use your skills to make an impact** **Required Qualifications** + Active unrestricted RN license with the ability to obtain Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work independently and within a team setting + Willing to work in multiple time zones + Strong written and verbal communication skills + Attention to detail, strong computer skills including Microsoft office products + Ability to work in fast paced environment + Ability to form positive working relationships with all internal and external customers **Preferred Qualifications** + Education: BSN or bachelor's degree in a related field + Experience with Physical Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare + Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual **Alert** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **Interview Format - HireVue** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. **Work-At-Home Requirements** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if approved by leadership. + Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **Benefits** Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including: + Health benefits effective day 1 + Paid time off, holidays, volunteer time and jury duty pay + Recognition pay + 401(k) retirement savings plan with employer match + Tuition assistance + Scholarships for eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-25-2025 **About us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************
    $71.1k-97.8k yearly Easy Apply 30d ago
  • Clinical Review Nurse - Concurrent Review

    Actalent

    Utilization review nurse job in Jackson, MS

    Schedules Available: + Monday-Friday, 10:30 AM - 7:00 PM CST + Friday-Monday, 8:00 AM - 6:30 PM CST + Wednesday-Saturday, 8:00 AM - 6:30 PM CST + Sunday-Wednesday, 8:00 AM - 6:30 PM CST Position Overview We are seeking Clinical Review Nurses to join our remote team. In this role, you will perform concurrent reviews to evaluate medical necessity, determine appropriate levels of care, and contribute to discharge planning. You will also collaborate with providers and medical directors, document findings, and support the creation of denial correspondence that meets NCQA and state standards. Key Responsibilities + Conduct concurrent reviews to assess member health, care setting, and medical necessity + Review acuity, resource use, length of stay, and discharge planning for quality and continuity of care + Collaborate with Medical Affairs and Medical Directors on care determinations + Document findings, discharge plans, and actions in health management systems + Work with providers to approve or recommend determinations based on review findings + Educate providers on utilization processes to ensure high-quality care + Support denial correspondence creation in clear, member-friendly language + Collaborate with care management teams for referrals and transitions of care Requirements + Graduate from an accredited School of Nursing or BSN with 2-4 years of related experience + Required Licensure: LPN/LVN or RN - Compact State License + Strong time-management skills and ability to work independently + Experience with electronic medical records (Epic, Trucare, Trucare Cloud preferred) + Knowledge of Medicaid or Medicare regulations and utilization management processes + Proficiency in Microsoft Word, Excel, and EHR systems Must Haves: + Compact Nursing License + Strong time-management and self-motivation + Experience with EMR systems + Medicaid, Medicare or insurance-related knowledge + Prior utilization management experience What We Offer + Fully remote role with national location flexibility (CST schedule required) + Highly engaged team culture with daily collaboration + Work-life balance with structured schedules and rotational holiday coverage Job Type & Location This is a Contract position based out of Jackson, MS. Pay and Benefits The pay range for this position is $33.00 - $40.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Dec 16, 2025. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.
    $33-40 hourly 10d ago
  • Registered Nurse (RN) Head Nurse 5C

    Baptist Anderson and Meridian

    Utilization review nurse job in Jackson, MS

    The Head Nurse is responsible for overseeing patient care, staff management and day to day operations of a specific department or nursing unit. Coordinates and provides care utilizing the critical thinking framework known as the nursing process. The nursing process forms the foundation of the nurse's decision making to help partner with patients/families to attain, maintain and restore health whenever possible. Blends caring, compassion, knowledge and integrity to provide safe quality care that preserves patient autonomy, dignity and rights. Assists manager by providing clinical leadership for nursing employees on an assigned unit to maintain continuity of nursing care in conjunction with the hospital/nursing mission, goals, policies and procedures. Works in collaboration with the Manager/Director/CNO to ensure goal attainment.system standard jd Responsibilities Interpret, review, and combine diagnostic data relevant to the patient's current condition. Collaborates with nursing leadership and other disciplines to identify opportunities for department improvements and drive change. Intervenes and provides guidance and direction during life threatening situations. Evaluates the effectiveness of interventions and expected outcomes. Implements innovative works processes that improve patient outcomes. Participates in clinical leadership activities such as coaching, counseling, mentoring, hiring, firing, yearly performance evaluations, staffing, payroll, and productivity. Participates in activities designed to improve health care delivery. Communicates/collaborates with others in providing patient care. Supports life-long learning. Completes other duties as assigned. Specifications Experience Minimum Required Minimum of 2 years experience on current unit or in like setting/specialty area. Preferred/Desired Education Minimum Required Preferred/Desired Training Minimum Required Preferred/Desired Special Skills Minimum Required Computer literacy Preferred/Desired Licensure Minimum Required RN; BLS CERTIFICATION WITHIN 14 DAYS OF HIRE Preferred/Desired ACLS
    $53k-98k yearly est. Auto-Apply 2d ago
  • Treatment Nurse Every Other Weekend

    Manhattan Nursing and Rehabilitation Center, LLC

    Utilization review nurse job in Jackson, MS

    Manhattan Nursing and Rehabilitation Center, LLC, is seeking Licenses Practical Nurses (LPN) Part-Time: Treatment Nurse for Every other Weekend Shifts: 7am - 3pm Every other Weekend Manhattan Nursing and Rehabilitation Center, LLC proudly serves our community's long-term care and rehabilitation needs. We are committed to providing loving excellence in senior care, specializing in individualized care. We offer services such as speech therapy, occupational therapy, physical therapy, and dementia/Alzheimer's care. Our goal is to provide dignified care to all of our residents in a well maintained, home-like environment. This level of care would not be possible without our compassionate and professional staff. This is an excellent opportunity offering competitive pay with great benefits. General Description of A LICENSED PRACTICAL NURSE (LPN) As a licensed nurse, you provide vital care and ensure our seniors are receiving outstanding health services. Your excellent collaboration assists in the oversight of CNAs. With effective communication, you discuss patient care and actively listen with an empathetic understanding of patients' healthcare needs. Your sensational organization and time management skills complete required documentation accurately and timely. You feel enormous value from assisting the senior community and guaranteeing exceptional care patients can count on. Our company recognizes the amazing efforts of our staff and values their downtime with a work-life balance that includes two weeks of vacation and sick days for a healthy rejuvenation that all employees supply to our patients. LICENSED PRACTICAL NURSE (LPN) QUALIFICATIONS -Current LPN license -High School Diploma or equivalent -At least 18 years old -Authorized to work in the United States Our ideal candidate preferably has previous nursing experience with completing treatments, completing assessments for skin issues, as well as excellent time management and organizational skills, able to work under pressure, can adapt to any environment or situation, and able to think critically and quickly to solve any problem that may arise. If this is you, we want you as part of our team! ARE YOU READY TO JOIN OUR NURSING TEAM? If you feel you'll be perfect as our full-time Licensed Practical Nurse (LPN), apply now using our initial 3-minute, mobile-friendly application. WE ARE AN EQUAL OPPORTUNITY EMPLOYER. ALL APPLICANTS WILL BE CONSIDERED FOR EMPLOYMENT WITHOUT ATTENTION TO RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN, VETERAN OR DISABILITY.
    $30k-50k yearly est. 59d ago
  • Treatment Nurse Every Other Weekend

    Manhattan NRC

    Utilization review nurse job in Jackson, MS

    Manhattan Nursing and Rehabilitation Center, LLC, is seeking Licenses Practical Nurses (LPN) Part-Time: Treatment Nurse for Every other Weekend Shifts: 7am - 3pm Every other Weekend Manhattan Nursing and Rehabilitation Center, LLC proudly serves our community's long-term care and rehabilitation needs. We are committed to providing loving excellence in senior care, specializing in individualized care. We offer services such as speech therapy, occupational therapy, physical therapy, and dementia/Alzheimer's care. Our goal is to provide dignified care to all of our residents in a well maintained, home-like environment. This level of care would not be possible without our compassionate and professional staff. This is an excellent opportunity offering competitive pay with great benefits. General Description of A LICENSED PRACTICAL NURSE (LPN) As a licensed nurse, you provide vital care and ensure our seniors are receiving outstanding health services. Your excellent collaboration assists in the oversight of CNAs. With effective communication, you discuss patient care and actively listen with an empathetic understanding of patients' healthcare needs. Your sensational organization and time management skills complete required documentation accurately and timely. You feel enormous value from assisting the senior community and guaranteeing exceptional care patients can count on. Our company recognizes the amazing efforts of our staff and values their downtime with a work-life balance that includes two weeks of vacation and sick days for a healthy rejuvenation that all employees supply to our patients. LICENSED PRACTICAL NURSE (LPN) QUALIFICATIONS -Current LPN license -High School Diploma or equivalent -At least 18 years old -Authorized to work in the United States Our ideal candidate preferably has previous nursing experience with completing treatments, completing assessments for skin issues, as well as excellent time management and organizational skills, able to work under pressure, can adapt to any environment or situation, and able to think critically and quickly to solve any problem that may arise. If this is you, we want you as part of our team! ARE YOU READY TO JOIN OUR NURSING TEAM? If you feel you'll be perfect as our full-time Licensed Practical Nurse (LPN), using our initial 3-minute, mobile-friendly application. WE ARE AN EQUAL OPPORTUNITY EMPLOYER. ALL APPLICANTS WILL BE CONSIDERED FOR EMPLOYMENT WITHOUT ATTENTION TO RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN, VETERAN OR DISABILITY. View all jobs at this company
    $30k-50k yearly est. 59d ago
  • FLIGHT NURSE

    Pafford Air of Ms LLC

    Utilization review nurse job in Jackson, MS

    Job DescriptionEssential Duties and Responsibilities Responsible for completion and submission of electronic patient care record for each dispatched flight within specified time frame Responsible for daily aircraft checks, which includes narcotic count Provide pre-hospital and intra-hospital advanced life support care from initial contact until patient care is relinquished to the accepting medical facility maintaining thorough patient care documentation Maintains competency in knowledge and psychomotor skills by participating in ongoing laboratory and clinical experiences Maintain documentation of required licensure, certifications, continuing education, safety, and advanced procedures Knowledgeable in use and routine maintenance of all equipment and supplies used by emergency programs (ground and air) Maintains positive interpersonal relationships with colleagues, EMS representatives, hospitals, and the public Functions as a medical flight member Attends pre-mission briefings and mission debriefing and completes necessary documentation Assists in pre-mission liftoff checklist and Pilot assistance when needed, i.e., radio, navigational, and visual observation activities Complies with safety standards to assure safety of self, medical personnel, patient, and equipment prior to liftoff Conducts aircraft safety briefings as needed Responsible for filling open or vacant shifts within assigned area as deemed appropriate by the Program Director Other Duties Participates regularly in activities, projects, and committees Attends and participates in meetings according to established guidelines Undertakes and maintains projects as assigned Acts as a mentor and/or participates in orientation of new employees Participates in continuing education programs Maintains awareness of current issues related to pre-hospital care through participation in professional activities, i.e., national, state legislative-elected or appointed Will instruct classes as directed by Program Director Will assist with PR and marketing at established bases where needed within the assigned area Other duties as assigned Qualifications Experience: Minimum of three (3) years' progressive experience in an emergency or critical care setting required Flight experience preferred Education: Current RN licensure in the states served by the assigned area required (Arkansas, Louisiana, and Mississippi) EMT Certification in state(s) where required to clear orientation BLS, ACLS, PALS, and NRP required Flight Certification (CFRN) required within 6 months of hire Skills Ability to read, analyze, and interpret health and flight-related journals, hospital reports, and job-specific legal documentation Ability to respond to inquiries or complaints from customers, regulatory agencies, or members of the business community Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals Ability to compute rate, ratio, and percent and to apply concepts of basic algebra and geometry to patient care Ability to define problems, collect data, establish facts, and draw valid conclusions Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables Ability to multitask and perform effectively in a fast-paced environment Exhibits professionalism, is ethical and able to maintain confidentiality Well-organized, analytical, and self-directed Excellent verbal and written communication skills; ability to relate to and interact with people at all levels of the organization Critical thinking skills with the ability to use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems Working Conditions and Mental/Physical Requirements Working Conditions: Required to work frequently near moving mechanical parts Required to work in outside weather conditions Frequently exposed to blood-borne pathogens or airborne particles Frequently exposed to vibrations/turbulence Exposed to loud noise levels requiring headphones while in-flight and at a moderate level when in a hospital environment Frequently required to travel within region of assignment Physical Demands: Reach with hands and arms; speak and hear Must possess the gross and fine motor skills necessary to sufficiently provide the full range of safe and effective patient care activities Frequently required to sit Required to stand, walk, climb or balance, stoop, kneel, crouch or crawl, and smell Lift and/or move up to 150 pounds cumulative with assistance Specific vision abilities required by this job include close vision, distant vision, peripheral vision, depth perception and the ability to adjust focus Must be able to work a flexible work schedule Note The above statements are intended to describe the general nature and level of work being performed by the person assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, skills, and physical demands required of personnel so classified. EEO Statement Pafford Air One is an Equal Opportunity Employer, which includes supporting veterans and providing reasonable accommodations for individuals with a disability.
    $30k-50k yearly est. 13d ago
  • New Graduate Nurse

    Fresenius Medical Care Windsor, LLC 3.2company rating

    Utilization review nurse job in Jackson, MS

    PURPOSE AND SCOPE: Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a Staff Registered Nurse, to ensure provision of quality patient care on a daily basis in accordance with FMS policies, procedures, and training. Supports the FMCNA's mission, vision, values, and customer service philosophy. Supports the FMCNA commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FMCNA Quality Enhancement Goals (QEP). Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies. Employees hired into this position will be required to obtain their nursing license and registration within the timeframe outlined in state specific regulations, or within 90 days from hire date, whichever comes sooner. PRINCIPAL DUTIES AND RESPONSIBILITIES: STAFF RELATED: Directs Patient Care Technician's provision of safe and effective delivery of chronic hemodialysis therapy to patients in compliance with standards outlined in the facility policy procedure manuals, as well as regulations set forth by the corporation, state, and federal agencies. Delegates tasks to all direct patient care staff including but not limited to LVN/LPNs, Patient Care Technicians, and Dialysis Assistants. Assesses daily patient care needs and develops appropriate patient care assignments. Routinely monitors patient care staff for appropriate techniques and adherence to facility policy and procedures. Participates in staff training and orientation of new staff as assigned Participates in all required staff meetings as scheduled. PATIENT RELATED: Education: Ensures educational needs of patients and family are met regarding End Stage Renal Disease (ESRD). Provides ongoing education to patients regarding their renal disease, vascular access and dialysis therapy, and other related health conditions. Discusses with patient, and records education related to diet/fluid and medication compliance. Provides patient specific detailed education regarding adequacy measures where applicable - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM). Ensures transplant awareness, modality awareness, and drive catheter reduction. Educates patients regarding laboratory values and the relationship to adequate dialysis therapy, compliance with treatment schedule, medications, and fluid. Dialysis Treatment: Provides safe and effective delivery of care to patients with ESRD. Accurately implements treatment prescriptions including Sodium (Na) modeling prescription, and Ultrafiltration modeling (where appropriate) to ensure stable treatment therapy as indicated. Assesses patients' response to hemodialysis treatment therapy, making appropriate adjustments and modifications to the treatment plan as indicated by the prescribing physician. Communicates problems or concerns to the Team Leader or physician. Identifies and communicates patient related issues to Team Leader or physician. Initiates Initial and Annual Nursing Assessment, and ongoing evaluation and documentation of patient care needs according to FMC Policies and Procedures. Actively participates in the pre evaluation, initiation, monitoring, termination, access homeostasis, and post evaluation of patients receiving hemodialysis treatment therapy according to established FMC procedures. Takes appropriate intervention for changes in patient adequacy status and troubleshooting access flow issues as identified by OLC/AMP yellow lights. Provides, supervises (if applicable), and monitors hemodialysis access care according to established procedures. Implements, administers, monitors, and documents patient's response to prescribed interdialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier. Ensures accurate and complete documentation by Patient Care Technician on the Hemodialysis Treatment Sheet. Laboratory-related: Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. Ensures appropriate preparation of lab requisitions for Spectra or alternate lab. Ensures correct labs tubes are utilized for prescribed lab specimens and that lab draw and processing procedures are performed appropriately for all lab samples. Identifies and ensures appropriate follow-through regarding missed labs and specimens reported to be insufficient according to company policies and procedures. Ensures all specimens are appropriately packaged according to Department of Transportation (DOT) policies and procedures relating to shipment of blood or body fluid specimens and potentially hazardous material. Ensures that all labs are directed and delivered to appropriate labs. Reports alert/panic and abnormal labs results to appropriate physician. Ensures lab results are forwarded to physicians as requested. General duties: Enforces all company approved policies and procedures, as well as regulations set forth by state and federal agencies and departments. Maintains overall shift operation in a safe, efficient, and effective manner. Act as a resource for other staff members. Routinely meets with the Clinical Manager to discuss personnel and patient care status, issues, and information. Collaborate and communicate with physicians and other members of the healthcare team to interpret, adjust, and coordinate care provided to the patient. Provides assistance as needed to patients regarding prescription refills according to FMCNA Policies. Ensures all physician orders are transcribed and entered into the Medical Information system in a timely manner. Oversees all documentation of patient information. Maintains facility drug list for all required stock medications. Maintains competency with all emergency operational procedures, and initiates CPR and emergency measures in the event of a cardiac and/or respiratory arrest. Ensures verification and availability of adequate emergency equipment. Ensures provision of appropriate vaccinations, immunizations, and annual Tuberculosis (TB) testing. Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification if indicated. Administers PRN medications as prescribed and completes appropriate documentation of assessment of effectiveness. Maintains appropriate recording of controlled substances as required by law. Assists with the coordination of patient transportation if necessary. MAINTENANCE/TECHNICAL: Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area. Ensures competency in the operation of all dialysis-related equipment safely and effectively. Ensures all patient stations, including machines and chairs, are clean and free of blood and placed appropriately. Ensures that all blood spills are immediately addressed according to FMCNA Bloodborne Pathogen Control Policies. MEDICAL RECORDS & DOCUMENTATION: General Ensures all relevant data including physician orders, lab results, vital signs and treatment parameters, and patient status are documented appropriately and entered into Medical Information System. Ensures all appropriate patient related treatment data is entered into the Medical Information System. Ensures all FMCNA policies regarding patient admission, transfer, and discharge are appropriately implemented. Ensures and verify accuracy of Patient Care Technician documentation. Daily Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets by all patient care staff. Ensures that all appropriate procedures are followed regarding opening and closing procedures, inclusive of monitoring that all staff and patients have safely left the premises. Monthly Initiates, documents, and completes ongoing Continuous Quality Improvement (CQI) activities including monthly reports. Completes monthly nurses' progress note. Ensures patient medical records are complete with appropriate information, documentation, and identification on each page (Addressograph label is on all chart forms). Reviews transplant status and follows established procedure regarding appropriate action to be taken. Completes patient care plans for new patients within the initial 30 days or any patients deemed unstable requiring monthly patient care plans. Completes any long-term programs that are due. Annually Completes initial and annual Nursing History and Assessment physical. Ensures completion of Annual Standing Order Review with each physician as required. OTHER: As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status (including renewal of such credentials or certifications prior to any expiration date). In the event that your credential or certified status changes, you must notify your supervisor immediately. Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs. Maintain regular and punctual attendance. Perform other related duties as assigned. Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. up as high as 5 feet. The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodation can be made. SUPERVISION: None EDUCATION: Graduate of an accredited School of Nursing. Current appropriate state Temporary Permit. Must meet the practice requirements in the state in which he or she is employed. EXPERIENCE AND REQUIRED SKILLS: 0 - 1 year's related experience. ACKNOWLEDGEMENT: I acknowledge that I have read and accepted this . I understand what is expected of me in this position, and I am able to perform the essential functions as outlined with or without reasonable accommodation. Furthermore, I understand that the duties and responsibilities listed in this are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. If I have any questions about duties and responsibilities not specified in this job description that I am asked to perform, I should discuss them with my immediate supervisor or my Human Resources representative. ADDENDUM: Managers in each state must determine if their state regulations permit employees to operate in this capacity, as well as the allowable duties and practice restrictions if permitted. Managers should consult their state-specific regulations at: *********************************************************************************************************************************************************** For additional information please contact your Regional Education Coordinator. The rate of pay for this position will depend on the successful candidate's work location and qualifications, including relevant education, work experience, skills, and competencies. Hourly Rate: $38.00-$55.36 for the Denver, CO locations. Other locations outside the state of CO will vary from this range. Benefits Overview: This position offers a comprehensive benefits package, including medical, dental, and vision insurance, a 401(k) with company match, paid time off, and parental leave. Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws. EOE, disability/veterans
    $35k-46k yearly est. Auto-Apply 18d ago
  • Treatment Nurse

    Woodlands Rehabilitation and Healthcare Center

    Utilization review nurse job in Clinton, MS

    Wound Care / Treatment Nurse for Skilled Long-Term Care FacilityLicensed Practical Nurse (LPN)7am - 7pm Excellent wage, based on experience Excellent Benefits Package Nexion is a "Great Place to Work" because we provide: Free employee and family telehealth immediately upon hire Medical / Dental / Vision Care Early Pay FSA / HSA / 401k Educational Advancement / increased pay with competency levels Scholarship for employees and dependents Emergency Relief Requirements:RN/LVN/LPN license required Learn more about Nexion at ********************* EOE M/F/D/V
    $30k-50k yearly est. 54d ago
  • New Graduate Nurse

    Fresenius Medical Care North America 4.3company rating

    Utilization review nurse job in Jackson, MS

    **PURPOSE AND SCOPE:** Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a Staff Registered Nurse, to ensure provision of quality patient care on a daily basis in accordance with FMS policies, procedures, and training. Supports the FMCNA's mission, vision, values, and customer service philosophy. Supports the FMCNA commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FMCNA Quality Enhancement Goals (QEP). Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies. Employees hired into this position will be required to obtain their nursing license and registration within the timeframe outlined in state specific regulations, or within 90 days from hire date, whichever comes sooner. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** **STAFF RELATED:** + Directs Patient Care Technician's provision of safe and effective delivery of chronic hemodialysis therapy to patients in compliance with standards outlined in the facility policy procedure manuals, as well as regulations set forth by the corporation, state, and federal agencies. + Delegates tasks to all direct patient care staff including but not limited to LVN/LPNs, Patient Care Technicians, and Dialysis Assistants. + Assesses daily patient care needs and develops appropriate patient care assignments. + Routinely monitors patient care staff for appropriate techniques and adherence to facility policy and procedures. + Participates in staff training and orientation of new staff as assigned + Participates in all required staff meetings as scheduled. **PATIENT RELATED:** Education: + Ensures educational needs of patients and family are met regarding End Stage Renal Disease (ESRD). + Provides ongoing education to patients regarding their renal disease, vascular access and dialysis therapy, and other related health conditions. + Discusses with patient, and records education related to diet/fluid and medication compliance. + Provides patient specific detailed education regarding adequacy measures where applicable - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM). + Ensures transplant awareness, modality awareness, and drive catheter reduction. + Educates patients regarding laboratory values and the relationship to adequate dialysis therapy, compliance with treatment schedule, medications, and fluid. Dialysis Treatment: + Provides safe and effective delivery of care to patients with ESRD. + Accurately implements treatment prescriptions including Sodium (Na) modeling prescription, and Ultrafiltration modeling (where appropriate) to ensure stable treatment therapy as indicated. + Assesses patients' response to hemodialysis treatment therapy, making appropriate adjustments and modifications to the treatment plan as indicated by the prescribing physician. Communicates problems or concerns to the Team Leader or physician. + Identifies and communicates patient related issues to Team Leader or physician. + Initiates Initial and Annual Nursing Assessment, and ongoing evaluation and documentation of patient care needs according to FMC Policies and Procedures. + Actively participates in the pre evaluation, initiation, monitoring, termination, access homeostasis, and post evaluation of patients receiving hemodialysis treatment therapy according to established FMC procedures. + Takes appropriate intervention for changes in patient adequacy status and troubleshooting access flow issues as identified by OLC/AMP yellow lights. + Provides, supervises (if applicable), and monitors hemodialysis access care according to established procedures. + Implements, administers, monitors, and documents patient's response to prescribed interdialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier. + Ensures accurate and complete documentation by Patient Care Technician on the Hemodialysis Treatment Sheet. Laboratory-related: + Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab requisitions for Spectra or alternate lab. + Ensures correct labs tubes are utilized for prescribed lab specimens and that lab draw and processing procedures are performed appropriately for all lab samples. + Identifies and ensures appropriate follow-through regarding missed labs and specimens reported to be insufficient according to company policies and procedures. + Ensures all specimens are appropriately packaged according to Department of Transportation (DOT) policies and procedures relating to shipment of blood or body fluid specimens and potentially hazardous material. + Ensures that all labs are directed and delivered to appropriate labs. + Reports alert/panic and abnormal labs results to appropriate physician. + Ensures lab results are forwarded to physicians as requested. General duties: + Enforces all company approved policies and procedures, as well as regulations set forth by state and federal agencies and departments. + Maintains overall shift operation in a safe, efficient, and effective manner. + Act as a resource for other staff members. + Routinely meets with the Clinical Manager to discuss personnel and patient care status, issues, and information. + Collaborate and communicate with physicians and other members of the healthcare team to interpret, adjust, and coordinate care provided to the patient. + Provides assistance as needed to patients regarding prescription refills according to FMCNA Policies. + Ensures all physician orders are transcribed and entered into the Medical Information system in a timely manner. + Oversees all documentation of patient information. + Maintains facility drug list for all required stock medications. + Maintains competency with all emergency operational procedures, and initiates CPR and emergency measures in the event of a cardiac and/or respiratory arrest. + Ensures verification and availability of adequate emergency equipment. + Ensures provision of appropriate vaccinations, immunizations, and annual Tuberculosis (TB) testing. + Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification if indicated. + Administers PRN medications as prescribed and completes appropriate documentation of assessment of effectiveness. + Maintains appropriate recording of controlled substances as required by law. + Assists with the coordination of patient transportation if necessary. **MAINTENANCE/TECHNICAL:** + Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area. + Ensures competency in the operation of all dialysis-related equipment safely and effectively. + Ensures all patient stations, including machines and chairs, are clean and free of blood and placed appropriately. + Ensures that all blood spills are immediately addressed according to FMCNA Bloodborne Pathogen Control Policies. **MEDICAL RECORDS & DOCUMENTATION:** General + Ensures all relevant data including physician orders, lab results, vital signs and treatment parameters, and patient status are documented appropriately and entered into Medical Information System. + Ensures all appropriate patient related treatment data is entered into the Medical Information System. + Ensures all FMCNA policies regarding patient admission, transfer, and discharge are appropriately implemented. + Ensures and verify accuracy of Patient Care Technician documentation. Daily + Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets by all patient care staff. + Ensures that all appropriate procedures are followed regarding opening and closing procedures, inclusive of monitoring that all staff and patients have safely left the premises. Monthly + Initiates, documents, and completes ongoing Continuous Quality Improvement (CQI) activities including monthly reports. + Completes monthly nurses' progress note. + Ensures patient medical records are complete with appropriate information, documentation, and identification on each page (Addressograph label is on all chart forms). + Reviews transplant status and follows established procedure regarding appropriate action to be taken. + Completes patient care plans for new patients within the initial 30 days or any patients deemed unstable requiring monthly patient care plans. + Completes any long-term programs that are due. Annually + Completes initial and annual Nursing History and Assessment physical. + Ensures completion of Annual Standing Order Review with each physician as required. **OTHER:** + As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status (including renewal of such credentials or certifications prior to any expiration date). In the event that your credential or certified status changes, you must notify your supervisor immediately. + Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs. + Maintain regular and punctual attendance. + Perform other related duties as assigned. **_Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions._** **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. up as high as 5 feet. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodation can be made. **SUPERVISION:** + None **EDUCATION** **:** + Graduate of an accredited School of Nursing. + Current appropriate state Temporary Permit. + Must meet the practice requirements in the state in which he or she is employed. **EXPERIENCE AND REQUIRED SKILLS** **:** + 0 - 1 year's related experience. **ACKNOWLEDGEMENT:** I acknowledge that I have read and accepted this . I understand what is expected of me in this position, and I am able to perform the essential functions as outlined with or without reasonable accommodation. Furthermore, I understand that the duties and responsibilities listed in this are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. If I have any questions about duties and responsibilities not specified in this job description that I am asked to perform, I should discuss them with my immediate supervisor or my Human Resources representative. **ADDENDUM:** Managers in each state must determine if their state regulations permit employees to operate in this capacity, as well as the allowable duties and practice restrictions if permitted. Managers should consult their state-specific regulations at: ********************************************************************************************************************************************************** . For additional information please contact your Regional Education Coordinator. The rate of pay for this position will depend on the successful candidate's work location and qualifications, including relevant education, work experience, skills, and competencies. Hourly Rate: $38.00-$55.36 for the Denver, CO locations. Other locations outside the state of CO will vary from this range. Benefits Overview: This position offers a comprehensive benefits package, including medical, dental, and vision insurance, a 401(k) with company match, paid time off, and parental leave. **Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**
    $41k-48k yearly est. 60d+ ago
  • Nurse Auditor 2

    Humana 4.8company rating

    Utilization review nurse job in Jackson, MS

    **Become a part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical documentation to ensure capture of all relevant coding. Applies clinical and coding experience to conduct a clinical validation review of the inpatient medical record to validate billed diagnoses. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. **Use your skills to make an impact** **WORK STYLE:** Remote/Work at Home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day, 5 days/week. Associates are expected to start each day between 6AM and 9AM in their home time zone. **Required Qualifications** + Active Registered Nurse (RN) license in the state they reside. + Minimum of 2 consecutive years acute inpatient hospital care experience in critical, intensive care setting within the last 5 years (Not pediatrics or neonatal). For example: ICU, CCU, PCU, med-surg/adult units or a minimum of 2 years DRG Inpatient auditing. NOTE: Inpatient experience does **not** refer to any other levels of care such as ER, OR, Pre-op, PACU,L&D, mother-baby, behavioral health, SNF, care manager/discharge manager, LTC, rehab, outpatient or office/clinic visits such as wound care, oncology, radiology, interventional radiology, lab, hospice, or home health. + In depth knowledge and critical understanding of complex medical diagnoses including, but not limited to, Sepsis (including end-organ failure), Pneumonia, Acidosis, Renal Failure, Encephalopathy, CVA, DKA, MI, etc. + Advanced knowledge of MS Office (Word, Excel, etc) + Excellent writing, editing, interpersonal, planning, teamwork, and communications skills + Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information + Ability to work independently and manage workload + Customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession **Preferred Qualifications** + Bachelor's Degree in relevant field preferred + Inpatient coding certification (AHIMA or AAPC - ex: RHIA, RHIT, CCS, CIS, CIC) + Inpatient coding claim experience + Prospective payment methodologies, DRG auditing experience + Clinical documentation improvement knowledge (CDE, CDEI certification) **Additional Information** **Work at Home Requirements** - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested - Satellite, cellular and microwave connection can be used only if approved by leadership - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Interview Format** As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $78,400 - $107,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $78.4k-107.8k yearly 60d+ ago
  • Nurse Part Time

    Pine Forest 4.0company rating

    Utilization review nurse job in Jackson, MS

    ←Back to all jobs at Pine Forest Nurse Part Time The primary purpose of the Licensed Practical Nurse position is to provide direct nursing care to residents as a member of an interdisciplinary team of care providers and to plan, supervise and evaluate the day-to-day nursing activities performed by nursing assistants. JOB DUTIES & RESPONSIBILITIES: Administrative Functions · Plan, assign, supervise and evaluate all responsibilities to be performed by members of the nursing staff under your supervision, so that care and services are provided on the basis of staff qualifications, resident acuity, required duties and physical layout of the facility. · Provide leadership, mentoring and guidance to associates for whom you are responsible. · As requested by the Director of Nursing or designee, assist in reviewing department policies, procedures and job descriptions and making recommendations for revisions. · Implement and monitor compliance with all established policies and procedures. · Meet regularly with your assigned nursing staff and support personnel to plan and communicate appropriate care-related services and activities for your residents, communicate residents' concerns and needs and discuss other vital information related to resident care and facility practices. Develop staff assignments as indicated. · Cooperate with other resident services to ensure that residents' individual care plans are being followed. · Participate in the facility's quality improvement to discuss resident, personnel and facility related business. · Meet with other nursing service and facility personnel on a regularly scheduled basis, to assist in identifying and correcting problem areas and/or improve services. · Review complaints made by your assigned personnel and communicate such information to the Director of Nursing or designee, as appropriate. · Participate in facility surveys made by authorized regulatory agencies. · Participate in the admission, transfer and discharge of residents as required. Nursing Care Functions · Implement and maintain established facility objectives, consistent with federal and state licensure regulations and nursing standards of practice. · Follow the facility's policies and procedures governing the provision of direct care to residents, including the administration of medications, treatments and other care in accordance with physicians' orders and the residents' care plans. · Perform continual observation and evaluation of each resident's physical, mental, cognitive and emotional status and Director of Nursing or designee, to the attending physician and to the resident's responsible party, according to facility policy and protocol. · Communicate timely with physicians and/or nurse practitioners related to resident care needs and concerns. Be responsible to properly implement and communicate to other caregivers all physician &/or nurse practitioner orders. · Respond immediately to resident events, accidents, incidents and/or allegations of resident abuse, neglect and/or misappropriation of property. Perform an assessment of the involved resident(s) and provide emergency intervention as required. Notify the Director of Nursing or designee, the Administrator (as appropriate), the resident's attending physician and the resident's responsible party when the resident is involved in an accident/incident. Initiate an immediate investigation of the accident/incident/unusual circumstance, when indicated, and in accordance with facility policy & procedures. · Attend in-service education programs in order to stay current in your profession and practice and meet facility educational requirements. · Conduct weekly skin checks and document/report findings to unit manager. Documentation · Document all clinical information in an informative and descriptive manner that reflects the care provided to the resident as well as the resident's response to the care. · Comply with state, federal, facility and other regulatory guidelines in terms of the frequency and type of documentation required. Care Plan and Assessment Functions · Develop and/or revise the residents' care plans on admission and as otherwise indicated. · Collect and continually contribute resident assessment data to assist in determining resident problems, goals and interventions, based on each resident's individual needs. Human Resource Functions · Recommend to the Nurse Educator the skill development and knowledge acquisition needs of your assigned staff. Participate in conducting in-service training classes that meet those needs, as requested. · Participate through serving as a “preceptor” in the orientation for new associates. · Assist in responding to staffing shortages by arranging for replacement staff or revising care assignments, as directed. · Participate in performance evaluations for your assigned staff through the provision of information to the Director of Nursing or designee. Safety and Sanitation Functions · Report occupational exposures to blood, body fluids, infectious materials, and hazardous chemicals in accordance with the facility's policies and procedures. · Monitor your assigned personnel to ensure that they are following established safety and sanitation regulations, policies and procedures. · Assist the Infection Control Coordinator in identifying, evaluating and classifying routine and job-related functions to ensure that tasks in which there are potential exposure to blood/body fluids are properly identified and recorded. · Ensure that all personnel participate in appropriate in-service training programs prior to performing any tasks that involve exposure to blood/body fluids. · Ensure that your assigned work areas are maintained in a clean and sanitary manner. Resident Rights' Responsibilities · Maintain the confidentiality of all resident care information. · Monitor nursing care to ensure that all residents are treated fairly, and with dignity, kindness and respect. · Ensure that all nursing care is provided in privacy and that nursing service personnel knock before entering the resident's room. · Ensure that all nursing service personnel are knowledgeable of and honor the residents' responsibilities and rights including the right to refuse treatment. · Review complaints and grievances made by the resident &/or family and make a written/oral report to the Director of Nursing or designee indicating what action(s) were taken to initially address the complaint or grievance · Report and begin the initial investigation of all allegations of resident abuse, neglect and/or misappropriation of resident property. Working Conditions · Works throughout the nursing service area (drug rooms, nurses' station, resident rooms, etc.)as well as other areas of the facility. · Moves intermittently during work hours. · Is subject to frequent interruptions. · Is involved with residents, personnel, visitors, government agencies/personnel, under all conditions and circumstances. · Is subject to hostile and emotionally upset residents, family members, personnel and visitors. · Communicates with the medical staff, nursing personnel and other department supervisors. · Works beyond normal working hours and in other positions temporarily, when necessary. · Is subject to callback during emergency conditions. · Attends and participates in continuing educational programs. · Is subject to exposure to infectious waste, diseases, conditions, etc. including TB and the AIDS and Hepatitis B viruses. · Is subject to injury from falls, burns from equipment, odors, etc., throughout the workday, as well as to reactions from dust, plastics, synthetics, disinfectants, tobacco smoke, and other potential contaminants. · May be subject to the handling of and exposure to hazardous chemicals. · Maintains a liaison with the resident, their families, support departments, etc. to adequately plan for the residents' needs. JOB REQUIREMENTS: Education · Must be a graduate from an accredited school for Licensed Practical Nurses with a current, unencumbered, active license to practice as an LPN. Experience Must have prior supervisory experience with supervising CNA's and other personnel. Specific Requirements · Must possess a current, unencumbered, active license to practice as an LPN in this state. · Must be able to read, write, speak and understand the English language. · Must display professionalism both in appearance and attitude. · Must possess the ability to solve problems and make independent decisions when circumstances warrant such action. · Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agency personnel and the general public. · Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long-term care. · Must possess the ability and the willingness to work harmoniously with and to coach and supervise other personnel. · Must be able to plan, organize, develop, implement and interpret the programs, goals, objectives, policies and procedures that are necessary for providing quality care. · Must have patience, tact, a cheerful disposition and enthusiasm, as well as the willingness to handle difficult personnel. · Must be willing to seek out new methods and principles and be willing to incorporate them into existing nursing practices. · Must be able to relate information concerning a resident's condition. · Must not pose a direct threat to the health or safety of other individuals in the workplace. Physical and Sensory Requirements · Must be able to move intermittently throughout the workday. · Must be able to speak and write the English language in an understandable manner. · Must be able to cope with the mental and emotional stress of the position. · Must be able to see and hear or use prosthetics that will enable these senses to function adequately to ensure that the requirements of this position can be fully met. · Must function independently and have flexibility, personal integrity, and the ability to work effectively with residents, personnel, and support agencies. · Must meet the general health requirement set forth by the policies of this facility, which include a medical and physical examination. · Must be able to relate to and work with the ill, disabled, elderly, emotionally upset, and at time hostile people within the facility. · Must meet the general health requirements set forth by the policies of this facility, which include a medical and physical examination. · Must be able to push, pull, move, and/or lift a minimum of five (5) pounds to a minimum height of three (3) feet and be able to push, pull, move, and/or carry such weight a minimum distance of five (5) feet. · Must be able to assist in the evacuation of residents during emergency situations. · Sitting: 1 hour per 8-hour shift. Alternates frequently to standing or walking. · Standing: 1-2 hours per 8-hour shift. Alternates frequently to walking and occasionally to sitting. · Walking: 5-6 hours per 8 hour shift. Alternates frequently to standing and occasionally to sitting. · Lifting: 1-10 lbs. Continuously 11-20 lbs. Continuously 21-75 lbs. Frequently > 75 lbs. Frequently · Carrying: 1-10 lbs. Continuously 11-20 lbs. Frequently 21-35 lbs. Occasionally · Driving: Rarely · Pushing: Frequently · Bending: Continuously · Squatting: Frequently · Kneeling: Occasionally · Crawling: Rarely · Climbing: Rarely · Reaching: Continuously · Grasping: Frequently · Fine Manipulation: Frequently (Frequency: Never=0%; Rarely=1-10%; Occasionally=11=33%; Frequently = 34-66%; Continuously = 67%+) Equal Employment Opportunity/Affirmative Action Employer and do not discriminate on the basis of race, color, age, sex, religion, veteran's status, national origin, disability, marital status, or any other characteristic protected by law. Please visit our careers page to see more job opportunities.
    $39k-46k yearly est. 60d+ ago
  • Nursing - L&D

    Merit Health River Oaks

    Utilization review nurse job in Flowood, MS

    Are you ready to take your Travel career to the next level? See places you have not seen before? Ventura's MedStaff tenured Recruiters are here to help you find your ideal contract; with over 50 years of combined experience. Markets have changed, but Ventura MedStaff has maintained a leader in the forefront of Therapy, Allied and Nursing opportunities. Our recruiters are here to help answer your questions and provide you with the most up to date information. Contracts run 8-13 weeks, with 36-40-hour guarantees, flexible start dates, and a mix of schedules. Contact one of our dedicated Recruiters to discuss more details. Ventura MedStaff benefits represent the care and compassion we provide for our clients. • Health, dental, vision, life, disability benefits and 401k • Tax free stipends when applicable • Gym discounts • Weekly pay • $750.00 referral bonus Please apply or contract us at: *********************** or ************
    $30k-50k yearly est. 2d ago
  • RN 7p-7a (5/2 split) - Skilled Nursing (TC) - St. Catherine's Village

    Fmolhs

    Utilization review nurse job in Madison, MS

    Coordinates pharmacy based admission medication history services using the health team philosophy practice model. Coordinates medication history services activities with PCS and ancillary departments. Maintains standards of department and the hospital. Serves as a resource for coworkers, physicians, patients and other hospital personnel. Coaches and counsels assigned employees to an optimal level of performance. Assists with ongoing process of performance management of assigned employees. Directs and supervises functions and activities of Med Reconciliation LPNs in the absence of the Pharmacy Operations Manager. Interprets and implements policies, procedures, standards and regulations. Reports to Pharmacy Operations Manager. Responsibilities Performs accurate drug history for each assigned patient during the admission process. Documents an accurate patient medication history in the patient record and in the Patient, Allergies, & Medication (PAM) module of the electronic medical record. Identifies discrepancies between home medication lists and the medications ordered at admission. Communicates identified discrepancies to the physician and takes telephone orders to change the medications as necessary. Communicates to the physician and other health care providers issues related to the patient's home medications, including, but not limited to non-compliance or poor understanding of regimens. Demonstrates good judgement and decision making skills; demonstrates the ability to assess a situation, research additional information and communicate appropriate information to the physician. Remains current with technology and resources necessary to perform medication reconciliation/medication histories, including electronic drug information resources, electronic medical record system, and pharmacy information system. Participates in all related education opportunities, especially programs related to the process of medication reconciliation, effective communication and medication use. Requires little supervision to carry out responsibilities. Uses resources effectively and efficiently, coordinates workflow so that medication histories are performed in a timely manner. Able to adapt to changes in acuity and workload. Remains flexible during staffing changes. Participates in planning changes and improvements. Creates are working climate that provides growth and job satisfaction of personnel. Demonstrates support of departmental policies. Exhibits a professional attitude when dealing with patient, patient's family members, co-workers and physicians. Demonstrates good rapport and teamwork with all pharmacy staff and other disciplines. Continually seeks new ways of improving policies and procedures that enhance the pharmacy based admission medication history program. Works with pharmacy leadership to identify new programs and processes that maximally utilize staff to support best clinical practices. Leadership Capabilities Demonstrates leadership ability. Organizes and coordinates functions and activities of pharmacy based LPNs. Assigns duties to medication history personnel in absence of Pharmacy Operations Manager. Serves as a preceptor for new employees as needed. Coaches and counsels assigned staff to an optimal level of performance and documents accordingly. Participates in, coordinates and conducts employee orientation, educational programs, in-service meetings and performance improvement plans. Enhances personal professional growth and development through participation in educational programs, current literature, in-service meetings and workshops. Qualifications Graduate of an accredited program in nursing. Requires relevant clinical experience, requires knowledge of hospital computer systems and computer-assisted devices. Requires problem-solving skills and ability to make independent judgments. Must have good verbal and written communication skills. Must have ability to prioritize and ability to be involved with multiple tasks and projects. Requires ability to work with others and requires close attention to detail. Employee must demonstrate ability to recognize patients' individual needs based on medical conditions, age adolescents, young adults, middle-aged and geriatric), limitations and planned procedures. Requires good judgment in delivering patient care; good oral and written communication skills; ability to function in stressful situations; Must be willing to rotate shifts, days off and work area; may occasionally be required to work overtime. Current Registered Nurse license to practice in the state. current review in CPR.
    $30k-50k yearly est. Auto-Apply 60d+ ago
  • Registered Nurse (RN) - Head Nurse - Oncology

    Baptist 3.9company rating

    Utilization review nurse job in Jackson, MS

    The Head Nurse is responsible for overseeing patient care, staff management and day to day operations of a specific department or nursing unit. Coordinates and provides care utilizing the critical thinking framework known as the nursing process. The nursing process forms the foundation of the nurse's decision making to help partner with patients/families to attain, maintain and restore health whenever possible. Blends caring, compassion, knowledge and integrity to provide safe quality care that preserves patient autonomy, dignity and rights. Assists manager by providing clinical leadership for nursing employees on an assigned unit to maintain continuity of nursing care in conjunction with the hospital/nursing mission, goals, policies and procedures. Works in collaboration with the Manager/Director/CNO to ensure goal attainment.system standard jd Responsibilities Interpret, review, and combine diagnostic data relevant to the patient's current condition. Collaborates with nursing leadership and other disciplines to identify opportunities for department improvements and drive change. Intervenes and provides guidance and direction during life threatening situations. Evaluates the effectiveness of interventions and expected outcomes. Implements innovative works processes that improve patient outcomes. Participates in clinical leadership activities such as coaching, counseling, mentoring, hiring, firing, yearly performance evaluations, staffing, payroll, and productivity. Participates in activities designed to improve health care delivery. Communicates/collaborates with others in providing patient care. Supports life-long learning. Completes other duties as assigned. Specifications Experience Minimum Required Minimum of 2 years experience on current unit or in like setting/specialty area. Preferred/Desired Education Minimum Required Preferred/Desired Training Minimum Required Preferred/Desired Special Skills Minimum Required Computer literacy Preferred/Desired Licensure Minimum Required RN; BLS CERTIFICATION WITHIN 14 DAYS OF HIRE Preferred/Desired ACLS
    $17k-36k yearly est. Auto-Apply 60d+ ago
  • SUPV - NURSING (RN) (PART - TIME) (WEEKENDS)

    Universal Health Services 4.4company rating

    Utilization review nurse job in Flowood, MS

    Responsibilities Registered Nurse (RN) Supervisor Opportunity - PART TIME- WEEKENDS ONLY Full-Time positions are eligible for our $10,000.00 sign-on bonus! Brentwood Behavioral Healthcare is seeking a dynamic and talented full-time RN. There is opportunity for overtime and to cover various shifts if interested. Brentwood Behavioral Healthcare is a 120 bed capacity behavioral health facility that provides psychiatric services. We specialize in treatment for adults, children and adolescents. Brentwood Behavioral offers both inpatient and outpatient psychiatric services. Located in Flowood, MS, in Rankin County with close proximity to Hinds and Madison Counties, our outpatient services are within driving distance to many surrounding areas. We help individuals and families achieve optimal mental health, resulting in improved quality of life. Our dedicated team of professionals provides individualized treatment, meeting the personal needs of our customers in a safe and nurturing environment. Visit our website @ ************************* WHAT DO OUR CURRENT EMPLOYEES VALUE AT BRENTWOOD AND UHS? An environment that puts patient care first. One of the most rewarding aspects of this job is providing excellent care, comfort, and security to the patients and families you treat, at their most vulnerable times. Supportive and responsive leadership. You are never alone, as you are part of a large network of peer co-workers that routinely exchange ideas and review current topics within the industry. Having the opportunity to grow, learn, and advance in your career. There are very robust continuing education options and opportunities for skills diversification and career advancement with UHS. Qualifications Minimum: Graduate from an accredited school of nursing. Currently licensed as a registered professional nurse in Mississippi. Must demonstrate good mental health, be able to handle multiple pressures, possess critical thinking skills, observe and attend to details, and be able to initiate change. Preferred: A Bachelor of Science in Nursing with one year experience in psychiatric setting. Currently licensed as a registered professional nurse in Mississippi. About Universal Health Services One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $13.4 billion in 2022. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 94,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. *********** EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: ************************* or **************.
    $32k-45k yearly est. 2d ago
  • Nursing - CVICU

    Merit Health River Region

    Utilization review nurse job in Vicksburg, MS

    Medium sized facility in southern Mississippi is in need of help in their Cardiac ICU, immediate starts. They are looking for CVICU RN travelers to work 13 week assignments working 12 hour shifts. Candidates must have 2 or more years experience, be certified ACLS and BLS, and have prior travel experience. Current MS/Compact license is necessary. Call Ventura Medstaff today for more information at ************.
    $30k-50k yearly est. 30d ago
  • Nurse (Registered Nurse) - Direct Hire

    Department of Justice

    Utilization review nurse job in Yazoo City, MS

    Corrections professionals who foster a humane and secure environment and ensure public safety by preparing individuals for successful reentry into our communities. Corrections professionals who foster a humane and secure environment and ensure public safety by preparing individuals for successful reentry into our communities. Overview Help Accepting applications Open & closing dates 10/01/2025 to 09/30/2026 Salary $49,739 to - $113,441 per year Pay scale & grade GL 05 - 10 Locations Many vacancies in the following locations: Aliceville, AL Maxwell AFB, AL Talladega, AL Forrest City, AR Show morefewer locations (91) Phoenix, AZ Safford, AZ Tucson, AZ Atwater, CA Herlong Sierra Ordnance Depot, CA Lompoc, CA Long Beach, CA Los Angeles, CA Mendota, CA San Diego, CA Victorville, CA Florence, CO Littleton, CO Danbury, CT Coleman, FL Marianna, FL Miami, FL Miami-Dade County, FL Tallahassee, FL Atlanta, GA Jesup, GA Honolulu, HI Chicago, IL Greenville, IL Marion, IL Pekin, IL Thomson, IL Terre Haute, IN Leavenworth, KS Ashland, KY Inez, KY Lexington, KY Manchester, KY Pine Knot, KY Oakdale, LA Pollock, LA Fort Devens, MA Cumberland, MD Milan, MI Duluth, MN Rochester, MN Sandstone, MN Waseca, MN Springfield, MO Yazoo City, MS Butner Federal Correctional Complex, NC Berlin, NH Fairton, NJ Fort Dix, NJ Kings, NY Otisville, NY Ray Brook, NY Elkton, OH El Reno, OK Oklahoma City, OK Sheridan, OR Gregg Township, PA Kelly Township, PA Lewis Run, PA Loretto, PA Minersville, PA Philadelphia, PA Waymart, PA Guaynabo, PR Bennettsville, SC Edgefield, SC Estill, SC Salters, SC Yankton, SD Memphis, TN Bastrop, TX Beaumont, TX Big Spring, TX Bryan, TX Federal Medical Center Carswell, TX Fort Worth, TX Houston, TX La Tuna, TX Seagoville, TX Texarkana, TX Three Rivers, TX Jonesville, VA Prince George, VA Seatac, WA Grand Marsh, WI Alderson, WV Beaver, WV Bruceton Mills, WV Glenville, WV Morgantown, WV Welch, WV Remote job No Telework eligible No Travel Required Occasional travel - Travel may be required for training and/or work related issues. Relocation expenses reimbursed No Appointment type Permanent Work schedule Full-time - Registered Nurse Accelerated Promotion Program covers the 0610 series ranging from GL-05 through GL-10 grade levels. If eligible, this enables a Registered Nurse to promote up to twice at an accelerated pace through a training program. Service Competitive Promotion potential 10 - Grade 10 - Registered Nurse Accelerated Promotion Program covers the 0610 series ranging from GL-05 through GL-10 grade levels. If eligible, this enables a Registered Nurse to promote up to twice at an accelerated pace through a training program. Job family (Series) * 0610 Nurse Supervisory status No Security clearance Other Drug test Yes Bargaining unit status No Announcement number DHA-2026-0002 Control number 847130700 This job is open to Help The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Career transition (CTAP, ICTAP, RPL) Federal employees whose job, agency or department was eliminated and are eligible for priority over other applicants. Clarification from the agency This is a public notice under the Direct Hiring Authority open to all U.S. citizens. Please review instructions in the "
    $30k-50k yearly est. 60d+ ago
  • Nurse II

    State of Mississippi

    Utilization review nurse job in Georgetown, MS

    No available description Health/Prescription Insurance Eligible employees have the opportunity to participate in the state's health and prescription insurance program. Employees may select either single or family coverage with affordable co-payments. More detail can be found at Know Your Benefits. Wellness Benefits Employees are eligible for a wellness and health promotion program. This plan provides annual benefits for certain services with first-dollar coverage with no deductible. Life Insurance All eligible employees receive an actual term life insurance policy upon employment. The policy coverage is two times the employee's annual salary to a maximum of $100,000. More detail can be found at Life Insurance Choices. Optional Insurances Many agencies offer discounted premiums for dental, vision, and cancer insurance. Flexible Spending Accounts Many state agencies provide opportunity for employees to participate in pre-tax spending accounts. These accounts allow employees to withhold childcare expenses and unreimbursed medical expenses prior to application of state and federal taxes. Paid Personal Leave and Sick Leave Full-time employees receive paid time off for personal needs and for sick leave. Leave begins accruing after one month of employment and may be used as it is accrued. Employees earn approximately 18 days of personal leave annually and 12 days of sick leave annually. Military Leave In accordance with federal law, all employees serving in the armed forces or the military reserves are entitled to 15 days per year for military training. Holidays Employees receive up to 10 paid holidays to enjoy many of our nation's celebrations with family and friends. Retirement Programs The State of Mississippi provides all its employees a Defined Benefit/Defined Contribution Retirement Program. Employees become vested in the State's retirement system after 8 years of employment. Both you and your employing agency contribute toward your retirement. More detailed information regarding the State's retirement program can be found at *************************** Deferred Compensation State agencies offer several opportunities for their employees to participate in a deferred compensation voluntary retirement savings plan. More information can be found at Deferred Compensation. State Credit Union All state employees are eligible to participate in the Mississippi Public Employees' Credit Union. This organization offers state employees special savings and borrowing plans. For more information about this program, call ************. Tuition Reimbursement Many state agencies provide opportunities for their employees to achieve higher education through tuition reimbursement. Common programs include medical and nursing fields, accounting, and business/administrative fields. Career Development and Training The Mississippi State Personnel Board offers several management and administrative certification programs, as well as professional development courses to enhance employee value to the agency. Individual agencies also offer technical training and allow membership in professional organizations to employees in their specific fields of employment. Promotional Opportunities Employees who have completed 6 or more months of service are eligible for promotional opportunities within state government employment. Minimum qualifications must be met. Career Ladders Many job classifications provide career-ladder opportunities based upon attainment of competencies. These career ladders can increase an individual's salary, provided funds are available within the agency. 01 Do you have a valid license to practice as a Registered Nurse in the State of Mississippi? * Yes * No 02 How many years of experience do you have as a Registered Nurse? * No experience * 1 year of experience * 2 years of experience * 3 years of experience * 4 years of experience * 5 years of experience * 6 years of experience * 7 years of experience * 8 years of experience * 9 years of experience * 10 years of experience * More than 10 years of experience Required Question Employer State of Mississippi Address 210 East Capitol Street Suite 800 Jackson, Mississippi, 39201 Phone ************ ************ Website ********************************************************
    $30k-50k yearly est. 3d ago

Learn more about utilization review nurse jobs

How much does a utilization review nurse earn in Jackson, MS?

The average utilization review nurse in Jackson, MS earns between $37,000 and $64,000 annually. This compares to the national average utilization review nurse range of $47,000 to $89,000.

Average utilization review nurse salary in Jackson, MS

$49,000

What are the biggest employers of Utilization Review Nurses in Jackson, MS?

The biggest employers of Utilization Review Nurses in Jackson, MS are:
  1. Actalent
  2. Centerwell
  3. Evolent Health
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