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Utilization review nurse jobs in Salt Lake City, UT

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  • Clinical Reviewer, Nurse

    Evolent 4.6company rating

    Utilization review nurse job in Salt Lake City, UT

    **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 2d ago
  • Utilization Management Nurse

    Centerwell

    Utilization review nurse job in Salt Lake City, UT

    **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 29d ago
  • Utilization Review Nurse

    University of Utah Health

    Utilization review nurse job in Salt Lake City, UT

    As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA This position is responsible for maintaining the financial integrity of both the patient and the organization through the provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such care; achieved via managing the cost of care while providing timely and accurate information to third party payers and medical care team. This position may be required to access and administer medications within their scope of practice and according to state law. Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes. Responsibilities Applies approved utilization criteria to monitor appropriateness of admissions with associated levels of care and continued stay review. Communication to third-party payers for initial and concurrent clinical review. Reviews patient chart to ensure patient continues to meet medical necessity. Documentation of all actions and information shared with care team members or third-party payer. Alerts and discusses with physician/provider and case manager/discharge planner when patient no longer meets medical necessity criteria for the inpatient stay. Discusses with physicians the appropriateness of resource utilization. Tracks length of stay (LOS) and resource utilization to identify at risk patients. Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. Performs verbal/fax clinical review with payer as determined by nursing judgment and/or collaboration with the payer per university contractual obligation. Participant in UR Committee as needed. Collects data on variances in LOS, avoidable days, costs/barriers to discharge/transition and denied days. Prepares appeals on denied cases when appropriate. Knowledge / Skills / Abilities Ability to perform the essential functions of the job as outlined above. Demonstrated team leadership, relationship building, critical analysis, and written and verbal communication skills. Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. The ability to demonstrate knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual. Ability to work autonomously and as a team member. Qualifications QualificationsRequired One year Utilization Review or Case Management experience. Licenses Required Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the interstate compact if switching residency to State of Utah. Must maintain current Interstate Compact (multi-state) license if residency is not being changed to Utah. * Additional license requirements as determined by the hiring department. Qualifications (Preferred) Preferred Basic Life Support Health Care Provider card. Proficiency in application of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. Utilization Review Certification designation. Knowledge of CMS Regulations. Working Conditions and Physical Demands Employee must be able to meet the following requirements with or without an accommodation. This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions. This position does not provide care to patients. Physical Requirements Listening, Manual Dexterity, Reaching, Sitting, Speaking, Standing, Walking
    $47k-62k yearly est. Auto-Apply 60d+ ago
  • Utility Coordinator

    Kimley-Horn and Associates, Inc. 4.5company rating

    Utilization review nurse job in Salt Lake City, UT

    Kimley-Horn's Salt Lake City, Utah (UT) office is seeking a Utility Coordinator with 4+ years of experience to join their Roadway team! This is not a remote position. Responsibilities * Candidates must have a willingness to perform a variety of tasks supporting various project managers as required. Job duties may include, but are not limited to: * Partnering with UDOT and Municipal clients on utility coordination * Working on large scale projects that require internal and external client facing communication * Meeting coordination and ability to stay organized * As a critical member of the team, you will perform a variety of engineering tasks and will receive both on-the-job and formal training as well as mentorship and exposure to plan production, project financials, and client interactions Qualifications * 4+ years experience within Civil Engineering or Construction Management * Bachelors Degree from an ABET accredited university in the field of Civil Engineering or Construction Management * "Engineer-In-Training" or "Engineering Intern" certification preferred * Working knowledge of MicroStation/InRoads/OpenRoads and/or AutoCAD Civil 3D preferred * Excellent verbal, written and interpersonal skills * Strong sense of urgency and self-initiative to meet client deadlines * Detail-oriented with an ability to contribute to a positive work environment * Ability to work independently and as a team Why Kimley-Horn? At Kimley-Horn, we do things differently. People, clients, and employees are at the forefront of who we are. Clients know we prioritize achieving their goals and growing their success. Employees know our culture and approach to business are built on a desire to provide an environment for everyone to flourish. Our commitment to quality is only as good as the people behind it- that's why we welcome and develop passionate, hardworking, and proactive employees. We take pride in how our employee retention, robust benefits package, and company values have led to Kimley-Horn's placement on the Fortune "100 Best Companies to Work" list for 18 years! Key Benefits at Kimley-Horn * Exceptional Retirement Plan: 2-to1- company match on up to 4% of eligible compensation (salary + bonus) and additional profit-sharing contribution. * Comprehensive Health Coverage: Low-cost medical, dental, and vision insurance options. * Time Off: Personal leave, flexible scheduling, floating holidays, and half-day Fridays. * Financial Wellness: Student loan matching in our 401(k), and performance-based bonuses. * Professional Development: Tuition reimbursement and extensive internal training programs. * Family-Friendly Benefits: New Parent Leave, family building benefits, and childcare resources. Responsibilities - Candidates must have a willingness to perform a variety of tasks supporting various project managers as required. Job duties may include, but are not limited to: - Partnering with UDOT and Municipal clients on utility coordination - Working on large scale projects that require internal and external client facing communication - Meeting coordination and ability to stay organized - As a critical member of the team, you will perform a variety of engineering tasks and will receive both on-the-job and formal training as well as mentorship and exposure to plan production, project financials, and client interactions
    $43k-55k yearly est. Auto-Apply 7d ago
  • QM Nurse Consultant

    CVS Health 4.6company rating

    Utilization review nurse job in Salt Lake City, UT

    At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** As a QM Nurse Consultant you will be responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from clinical records or systems and uses clinical decision making to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider claims. + Independently coordinates the clinical resolution with clinician/MD support as required. + Considers all documentation provided including medical records and system documentation to evaluate post-service claims for payment based on clinical policies, legislation, regulatory requirements, and plan benefits. + Review requires navigation through multiple system applications as well as potential requirement to outreach to internal department or providers. + Accurately applies review requirements to assure case is reviewed according to all company policies and procedures as well as state and federal laws and regulations. + Adhere to company policies regarding confidentiality to protect member information. **Required Qualifications** - 5+ years of clinical experience required - 2+ years of experience as a Registered Nurse - Must have active, current and unrestricted RN licensure in state of residence - 1+ years of experience using Microsoft Office products, including Outlook and Excel, and previous experience using Internet Explorer and Google Chrome to effectively utilize review resources and conduct reviews. - Must be willing to work Monday through Friday 8:00am - 5:00pm in time zone of residence **Preferred Qualifications** - Utilization Management review - Managed Care experience **Education** Associates degree required **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $54,095.00 - $155,538.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 07/30/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
    $54.1k-155.5k yearly 60d+ ago
  • Field Nurse Practitioner (Salt Lake City, UT)

    Molina Healthcare 4.4company rating

    Utilization review nurse job in Salt Lake City, UT

    Provides screening, preventive primary care and medical care services to members - primarily in non-clinical settings where members feel most comfortable, including in-home, community and nursing facilities and “pop up” clinics. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Provides general medical care and care coordination to various and/or specific patient member populations - adult, women's health, pediatric, and geriatric. • Performs comprehensive evaluations including history and physical exams for gaps in care and preventive assessments. • Addresses both chronic and acute primary care complaints, and demonstrates ability to ascertain medical urgency. • Establishes and documents reasonable medical diagnoses. • Seeks specialty consultation as appropriate. • Orders/performs pertinent diagnostic laboratory and radiology testing for the medical diagnosis or presenting symptoms; works within an environment of limited resources and therefore uses diagnostic tests judiciously and appropriately. • Understands when a member's needs are beyond their scope of knowledge and when physician oversight is needed. • Creates and implements a medical plan of care. • Schedules appointments for visits when appropriate. • Provides post-discharge coordination to reduce hospital readmission rates and emergency room utilization. • Performs face-to-face in-person visits in a variety of settings including in-home, skilled nursing facilities, and public locations. • Performs face-to-face visits via alternative modalities based on business need, leadership direction and state regulations. • Orders bulk laboratory orders to target specific member populations. • Performs alternating on-call coverage to triage any urgent lab results and pharmacy inquiries and develops appropriate plans of care. • Participates in community-based “pop up clinics” to build relationships with communities, and address gaps in health care. • Drives up to 120 miles a day on a regular basis to a variety of locations within the assigned region. Drives beyond 120 miles as part of extended mileage may be required on special project days. Special projects may include an overnight hotel stay. • Obtains and maintains cross-state license in other states besides home state based on business need. • Collaborates with fellow nurse practitioners to develop best practices to perform work duties efficiently and effectively. • Actively participates in regional meetings. • May prescribe medications and perform procedures as appropriate. • Performs timely medical records documentation in electronic medical record (EMR) computer system. • On occasion, may be required to walk flights of stairs while carrying up to 50 lbs. of equipment. • Engages in practices constituting the practice of medicine in collaboration with and under the medical direction and supervision of a licensed physician to the degree required by state laws. • Local travel required (based upon state/contractual requirements). Required Qualifications • At least 1 year of experience as a nurse practitioner, or equivalent combination of relevant education and experience. • Active and unrestricted national certification from one of the following organizations: American Academy of Nurse Practitioners (AANP) or American Nurses Credentialing Center (ANCC). • Current state-issued license to practice as a Family Nurse Practitioner (FNP). License must be active and unrestricted in state of practice. • Prescriber Drug Enforcement Agency (DEA) license with authority to prescribe per state qualifications. License must be active and unrestricted in state of practice. • Current Basic Life Support (BLS) certification. • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to work independently with minimal supervision and demonstrate self-motivation. • Responsive in all forms of communication. • Ability to remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills; ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving and critical-thinking skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency, and electronic medical record (EMR) experience. Preferred Qualifications • Experience as a registered nurse or nurse practitioner in a home health, community health or public health setting. • Experience in home health as a licensed clinician, especially in management of chronic conditions. • Experience with underserved populations facing socioeconomic barriers to health care. • Immunization and point of care testing skills. • Bilingual. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V #PJNurse #HTF Pay Range: $88,453 - $172,484 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $88.5k-172.5k yearly 20d ago
  • Regional Nurse Consultant

    Avalon Health Care Group 4.2company rating

    Utilization review nurse job in Salt Lake City, UT

    Avalon Health Care Management, Inc. has an exciting opportunity for an experienced Registered Nurse for a Regional Nurse Consultant position! Travel required. Avalon is seeking an experience skilled nursing facility director of nursing who is ready to take the next step in their career as a regional nurse consultant or an experienced regional nurse consultant with a background working as a director or nursing in a skilled nursing facility. Must have DON or Regional Nurse experience in Skilled Nursing Starting at $130,000 /yr Full-time are eligible for: * 401K * Medical, Dental & Vision * FSA & Dependent Care FSA * Life Insurance * AD&D, Long Term Disability, Short Term Disability * Critical Illness, Accident, Hospital Indemnity * Legal Benefits, Identity Theft Protection * Pet Insurance and Auto/Home Insurance Responsibilities The Regional Nurse Consultant will be responsible for the provision of expert advice and oversight to facility management personnel and line staff to ensure that systems are maintained to effectively and efficiently operate the facility in a manner to safely meet residents' needs in compliance with federal, state and local requirements. * Resident Assessment/Care Plan Development * Delivery of Resident Care * Facility Support * Supervision * Customer Service * Residents' Rights * Resident Comfort and Safety * Pharmacy Knowledge * Lab Values * Infection Control * Continuing Education Qualifications * Previous Director of Nursing and/or Nurse Consulting experience for a Skilled Nursing Facility is required. * Understanding of CMS regulations and experience with the survey process. * A current, active license to practice as a Registered Nurse (RN) * Ability to travel to assignments. * Ongoing pursuit of Continuing Education Credits in clinical subjects, management, personal growth and development. * Demonstrate working knowledge of infection control principles and practices. * Ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, and policies and procedures that are necessary for providing quality care. * Proven ability to communicate effectively and positively with staff, residents and family members. * Basic understanding of computer technology. * Proven written and oral communication skills. * Proven decision-making and analytical skills. * Able to relate positively, favorably and cooperatively with others, including employees, residents, family members, and personnel of outside agencies and organizations. Avalon Health Care Group is an Equal Opportunity Employer. If you believe this posting does not comply with WA law, send notice to **************************.
    $130k yearly Easy Apply 2d ago
  • Field Nurse Practitioner - Davis County, Utah

    Advantmed 3.6company rating

    Utilization review nurse job in Farmington, UT

    Job Description Advantmed is a leading provider of risk adjustment, quality improvement and value-based solutions to health plans and providers. We drive market leading performance with integrated technology, service, and program solutions that optimize the risk and quality performance of our partners. Our solutions focus on identifying, managing, and documenting risk and quality performance, and the proactive clinical engagement of high acuity populations. The building B.L.O.C.K.S. of our team's success! Bring the fun Leverage together for better Outperform yourself Care at every touchpoint Keep your word. Keep it real Stay curious & listen well Primary Purpose: We are seeking a highly skilled and compassionate Nurse Practitioner to join our Advantmed provider network. In this role, you will be responsible for conducting in-home wellness risk adjustment assessments for Medicare and other populations. Your primary objective will be to assess the overall health and well-being of member beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care. NP Responsibilities: Perform annual wellness visits and health assessments on a population with chronic conditions Deliver patient health education opportunities Assist in closing quality care gaps (i.e. screenings and labs) An enthusiastic collaborator contributing to the enhancement of care delivery Providers are expected to commit a minimum of 30 hours per month Locations: Davis County, Utah Requirements NP Qualifications: Must have a valid unencumbered NP License for the state you will be working in Previous in-home Risk Assessment experience preferred 3 years patient care experience preferred (primary care/adult/geriatric, EMR) Bilingual is a plus Benefits Advantmed offers: Competitive wages (contractor per diem, per completed in-home assessment rate ~$100) Paid mileage Flexible work schedule Evening and weekend availability Dedicated coordinator support Advanced member scheduling coverage State of art technology
    $72k-106k yearly est. 1d ago
  • Utility Coordinator

    Sunpower Corp 4.5company rating

    Utilization review nurse job in Orem, UT

    Job Level: Entry-Level Shift: Full-Time Division: Blue Raven Solar Compensation: $15-16/hour Benefits: Full-time employees are eligible for Health, Dental, Vision, & Life and Accident insurance, an HSA Savings Account, and the opportunity to receive stock options. SunPower: With decades of experience, we are a U.S.-based solar company committed to providing reliable and sustainable energy and storage solutions. Clean energy and storage should be accessible to everyone. SunPower delivers all-in-one residential solar solutions with personal customer service, leading in sustainability through ethically sourced materials and low environmental impact. SunPower supports the transition to clean energy through streamlined, dependable solar solutions designed to meet diverse needs while minimizing environmental impact. By prioritizing ethically sourced materials and collaborating with nonprofit organizations, we are expanding access to solar technology and contributing to a more sustainable, resilient future. About Us: In 2025, Blue Raven Solar and Complete Solar came together under the trusted SunPower name. This transition brings together the strengths, expertise, and shared commitment to making clean energy simpler and more accessible for everyone. Position Summary: The Utility Coordinator plays a key role in ensuring the timely and accurate submission of utility interconnection applications for residential solar projects. This position is responsible for coordinating with utility companies and internal teams to manage the utility process from application to approval. The ideal candidate is organized, detail-oriented, and comfortable working in a fast-paced environment with strict timelines. Key Responsibilities: Prepare and submit residential utility interconnection applications in accordance with utility guidelines and timelines. Track the status of all submitted applications and follow up regularly with utility providers to ensure timely approvals. Review utility feedback and coordinate with internal teams (e.g., design, permitting, and project management) to resolve any corrections or resubmissions. Maintain and update utility requirements by region and ensure application packages remain compliant with local utility policies. Log recurring utility corrections in a central database to improve first-time submission accuracy. Support cross-functional teams with utility-related inquiries or escalations as needed. Required Qualifications: 1-2 years of experience in the solar industry preferred. Understanding of residential utility interconnection processes is a plus. Strong organizational and time-management skills with the ability to handle multiple projects simultaneously. Clear and professional written and verbal communication skills. High attention to detail and accuracy in data entry and documentation.
    $15-16 hourly 24d ago
  • OR Nurse

    Surgery Partners 4.6company rating

    Utilization review nurse job in Salt Lake City, UT

    In partnership with Intermountain Health, Surgery Partners is seeking experienced OR nurse to join our Team! We are open Tuesday-Friday. No Holidays! No Weekends! Our specialties include: cataracts, ENT, podiatry, ortho, plastics, oculoplastics and colorectal. Job Summary The Nurse Circulator assists in provision of nursing care to patients in an Ambulatory Surgical Center setting. Assumes total responsibility for patient care in accordance with physician's orders and centers policies. During operations and other surgical procedures, the circulator assists by acting as an intermediary between the operating room staff and the rest of the surgical center. Responsibilities * Performs circulating functions including monitoring, recording and communicating patient condition and managing overall nursing care of patient before, during and after procedure. * Prepares operating rooms including equipment and supplies for use. * Performs patient positioning and ensures patient safety throughout procedure. Qualifications: * Graduate of Accredited School of Nursing; current state RN license. * BLS required. * Minimum one year in the OR, ability to scrub as well as circulate preferred. Our employees are critical to our success and we value their contributions. Surgery Partners offers a competitive compensation and benefits package and an opportunity to grow and develop your career in an environment that values employee ideas and diversity. Equal Opportunity Employer. We maintain a drug-free workplace and require pre-employment drug screening. Benefits: * Comprehensive health, dental, and vision insurance * Health Savings Account with an employer contribution * Life Insurance * PTO * 401(k) retirement plan with a company match * And more! Equal Employment Opportunity & Work Force Diversity Our organization is an equal opportunity employer and will not discriminate against any employee or applicant for employment based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, parental status, sexual orientation, veteran status, genetic testing results or any other consideration made unlawful by federal, state or local laws. This practice relates to all personnel matters such as compensation, benefits, training, promotions, transfers, layoffs, etc. Furthermore, our organization is committed to going beyond the legal requirements of equal employment opportunity to take positive actions which ensure diversity in the workplace and result in a multi-cultural organization.
    $50k-65k yearly est. 23d ago
  • Ketamine Infusion Nurse (RN)

    Serenity Mental Health Centers 3.7company rating

    Utilization review nurse job in Salt Lake City, UT

    Looking for a Calmer Pace and Deeper Patient Impact? Join Serenity. Ketamine Infusion Nurse - RN At Serenity Healthcare, we believe in true healing for our patients. We're redefining what compassionate mental healthcare looks like by creating space for connection, clarity, and care. If you're an RN looking to step away from the high-pressure pace of hospital life and into a role where you can build relationships, support healing, and still protect your own well-being, this is the place for you. What Makes This Role Different As a Ketamine Infusion Nurse, you'll support patients on their mental health journey in a calm outpatient setting, free from the chaos of acute care. With no overwhelming patient loads and no night shifts, this position allows you to focus on quality care without compromising your personal time. What You'll Do Administer Ketamine IV infusions safely and effectively in a serene, supportive environment Monitor and comfort patients before, during, and after treatment Offer emotional reassurance, education, and clear communication to patients and families Keep detailed, thoughtful documentation Support clinical care remotely via telehealth on non-infusion days Pitch in where needed-teamwork is part of what makes our clinic thrive About Serenity Healthcare At Serenity, we use cutting-edge treatments and a deeply compassionate approach to help people rediscover their quality of life. Our team is grounded in evidence-based care and committed to supporting both patient transformation and clinician well-being. We're proud to be an equal opportunity employer - and we'd love to welcome you into a workplace that respects your expertise, your time, and your humanity. All hires are contingent on passing a criminal background check and drug screening. Requirements What You'll Need Active RN license (unrestricted) Graduation from an accredited nursing program Confidence with IV placement and maintenance Understanding of medication safety, sterile technique, and infection control Compassionate, calm, and clear communicator A mindset that values teamwork, empathy, and flexibility Benefits What You'll Love About Serenity 3-Day Work Week: Just three 12-hour shifts weekly (alternating Saturdays, never Sundays) Low Patient Volume: Only 2 patients per nurse at a time, so you can give each one your best Peaceful Work Setting: Outpatient clinic focused on healing, not hustle Competitive Pay based on your experience Exceptional Benefits: We cover 90% of medical, dental & vision premiums 401(k) to support your financial wellness PTO: 10 days to start (15 after your first year) + 10 paid holidays Employee referral program - great people know great people
    $49k-60k yearly est. Auto-Apply 60d+ ago
  • Nurse Paralegal

    Gordon Rees Scully Mansukhani, LLP 4.6company rating

    Utilization review nurse job in Salt Lake City, UT

    Gordon Rees Scully Mansukhani, a national law firm in all 50 States, has an immediate opening for a part-time medical records/nurse paralegal in our Salt Lake City office. Preferred qualifications include being a registered nurse or medical coder and having experience reviewing medical records in a legal setting and preparing medical chronologies for use at trial. Candidates should have a solid knowledge of litigation support, including organizing, reviewing, and analyzing medical records and producing medical chronologies that include a detailed summary of medical records that address complaints, claimed injuries, and medical treatment received as well as identifying additional records to be obtained. The firm offers a friendly, business casual environment with competitive salary and a full benefits package, including Medical, Dental, Vision, 401K, PTO, Disability & Life Insurance. Possibility of hybrid remote opportunity for qualified candidates. For consideration, please submit a cover letter, references and resume. Gordon Rees Scully Mansukhani is an equal opportunity employer. No recruiter emails or telephone calls. Disclaimer: Reposting positions from this website does not authorize search firms or other third parties to directly solicit candidates on the firm's behalf or represent a relationship with the firm. Agencies must sign GRSM's fee agreement. The firm's search agreements are specific to individuals and groups who will be considered on a case-by-case basis. Candidates submitted by a search firm without an executed search firm agreement will not be considered as an applicant. For consideration, please send a detailed blind profile of your candidate to: *******************.
    $57k-76k yearly est. Auto-Apply 21d ago
  • National Travel Nurse (RN)

    New Season 4.3company rating

    Utilization review nurse job in Woods Cross, UT

    Under the direction and supervision of the Medical Director or Registered Nurse for medical matters and under the direction of the Health Services Operations Manager for administrative matters participates in the promotion and restoration of patients' health, collaborates with physicians and multidisciplinary team members; and provides support to patients and all centers within New Season as needed. Essential Functions: * Supplies and administers medication pursuant to physician order and records dosage administered in the medical record. * Conducts an actual sight and counts inventory of the medication supply daily. * Maintains absolute accuracy in daily accounting of medication that is supplied or administered in inventory and assumes responsibility for safeguarding medication inventory. * Collects fees in the absence of a cashier position. * Performs daily cash reconciliation in the absence of a cashier position; ensures all cash collected is given to the Program Director daily so the final count can be completed. * Receives and ensures the accuracy of incoming medication shipments; advises necessary staff of any discrepancies in a timely fashion. * Ensures disposal of medical waste through the proper protocol. Observes the patient's demeanor prior to dosing and seeks guidance from the Medical Director or Registered Nurse when an issue or concern is noted. * Promptly communicates patient issues or concerns to the Medical Director or Registered Nurse for medical matters and to the Program Director for other matters. * The former includes but is not limited to dose requests, behavior, or any other aspect of patient care that may need to be addressed. * Contacts other centers to verify dosages as needed. * Administers appropriate lab tests as required including patient vital signs, TB tests when required, and collects data for review by Medical Director or RN. * Schedules and screens patients to be seen by the Medical Director. * Assists the Medical Director in collecting data for the history and physical as required. * Makes medical record entries as directed by the Medical Director or RN and consistent with clinic protocol. * Complies with federal and state privacy rules, including 42 CFR Part 2 and 45 CFR Parts 160 and 164 as well as applicable clinic policies and procedures. * Is responsible for obtaining and maintaining proper licensure and/or certification according to specific state requirements. * Actively participates in CARF preparation and state audit process. * Participates in all staff meetings. * Complies with all Local, State, Federal, and company rules, regulations, and policies. * Acts always in the best interest of patients, the program, and company; honors, supports, and protects the proprietary rights of patients and the company. * Interfaces with the public and patients by answering phones, greeting visitors, and monitoring patient activities while on center premises Must provide nurse services for multiple clinical locations as assigned and needed. * Performs other duties as required * Receives medical orders; ensures that medical orders are documented and signed by the physician and ensures orders are understood by the Program Director and other staff members as needed. * Maintains absolute control, tracking, and confidentiality of all patient medical paperwork. * Other duties as directed Supervisory Responsibilities (Scope of the person's authority, including a list of jobs that report to this job). Essential Qualifications: (To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the competencies (minimum knowledge, skill, and ability) required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions). Education/Licensure/Certification: Has and maintains multi-state compact RN licensure and CPR certification. Required knowledge: Understanding of opiate addiction, medical terminology, general nursing knowledge and techniques. Basic mathematics skills. Must be computer literate and have basic knowledge of all Microsoft productings and Google products. Must have basic typing skills. Experience required: Minimum of 1 year direct patient contact. Prior experience in Clinical environmental helpful. Skill and Ability: Must possess excellent customer service and interpersonal skills. Must have great attention to detail and be extremely accurate in performing daily functions.. Ability to travel via airplane. Job or State Requirements Compact RN License, Ability to travel 100 %
    $56k-69k yearly est. 22d ago
  • Dosing Nurse

    Tranquility Place of Utah LLC

    Utilization review nurse job in Salt Lake City, UT

    Job DescriptionBenefits: 401(k) Dental insurance Paid time off Tranquility Place is one of the last privately owned methadone clinics in Utah and we are looking to hire a dosing nurse. Going on ten years changing lives one person at a time. Relaxed, supportive, transparent, management. Interactive team spirit. Collaborative, supportive environment. A small company that cares for employees as well as for the people we serve. We offer strong team spirit and staff involvement, honesty and trust at all levels, and compassionate service to employees and clients alike. Job Requirements and Duties Must be at minimum a Licensed Practical Nurse (LPN) with an active license in the state of Utah Must pass background check Competent with computer and software (software training done in house) Administers medication to patients Hand out takehome doses Prepares specimens for UA lab
    $42k-63k yearly est. 5d ago
  • Nurse Case Manager- Ogden, UT

    The Ima Group 4.4company rating

    Utilization review nurse job in Ogden, UT

    Description Company Overview: Orchard Medical Consulting, an IMA Group Company, is a leading medical organization committed to providing high-quality, comprehensive medical assessments across various specialties. With a focus on occupational health, disability evaluations, and healthcare assessments, we strive to deliver exceptional care and support to our claimants. Job Summary: We are seeking a compassionate and experienced Nurse Case Manager to support individuals with work-related injuries. Our ideal candidate will conduct consultative exams, assessing both physical and psychological aspects without administering medical treatment. Our team of providers manage evaluations, screenings, and case management for Insurance Carriers, TPAs, Public Entities, and Employers. Responsibilities: Deliver tailored services for individuals affected by work-related injuries. Work closely with physicians and claims adjusters to craft efficient and budget-friendly treatment strategies. Foster and maintain robust relationships with our client base. Act as an essential liaison connecting patients with their healthcare providers. Qualifications: Associate of Science in Nursing (ASN) or higher-level nursing degree. Active Registered Nurse (RN) license required. CCM (Certified Case Manager) credential preferred. Proven clinical experience, ideally in ICU, ER, Trauma, Ortho, and/or Neurology. Experience in Workers' Compensation Nurse Case Management preferred. Benefits: Complete Health Coverage: Comprehensive Health, Dental, and Vision Insurance packages to ensure your well-being. Balanced Lifestyle: Enjoy paid time off, holidays, and a floating holiday to maintain a healthy work-life balance. Comprehensive Coverage: Benefit from LTD, STD, Flexible Spending Account, Company-paid Life Insurance, and ADD coverage. Stress-Free Environment: No on-call responsibilities ensure a stress-free work atmosphere. The IMA Group is an Affirmative Action/Equal Opportunity Employer Our Government Services Division supports local, state, and federal agencies and delivers professional and objective medical and psychological examinations as well as ancillary services. Our Payer Services Division meets the evaluation and screening needs of Carriers, TPAs, Public Entities and Employers and includes behavioral health and physical medicine specialty services, working with a wide range of organizations within the workers' compensation, disability, liability, and auto markets. Our Clinical Research Division performs all types of Phase II-IV clinical trials in multiple therapeutic areas through a flexible nationwide network of site locations and virtual capabilities. #LI-BC1#LI-HYBRID
    $52k-63k yearly est. Auto-Apply 8d ago
  • Infusion Nurse

    Start Center for Cancer Research 3.4company rating

    Utilization review nurse job in West Valley City, UT

    Job Description The START Center for Cancer Research (“START”) is the world's largest early phase site network, fully dedicated to oncology clinical research. Throughout our history, START has provided hope to cancer patients in global community practices by offering access to cutting edge trials throughout the US and Europe. Today, with over 1,300 studies completed, and with research facilities in the United States and in Spain, Portugal, and Ireland, START's mission is to accelerate the development of new anticancer drugs that will improve the quality of life and survival for patients with cancer and lead to its eventual cure. To date, over 43 therapies conducted at START locations have obtained FDA/EMA approval. Incredibly, while Academic Medical Centers (AMCs) conduct 80% of cancer trials, such trials reach only 20% of the patient population - leaving the majority of patients who are treated in community practices and hospitals without access to a clinical trial when their care journey calls for one. START serves the many - by bringing cancer trials to physicians and their patients in community hospitals and practices when hope is needed most. START represents the world's largest roster of Principal Investigators (PIs) across its eight clinical trial sites. Committed to accelerating passage from trials to treatments, START delivers hope to patients, families, and physicians around the world. As an example, in San Antonio, where START was founded, START treated the first patient ever with Keytruda - the most effective cancer drug in medical history. We are hiring an Infusion Nurse for our START Mountain Region office in West Valley City, UT. The Infusion Nurse is responsible for providing direct patient care to individuals who are participants in research protocols that are conducted at START. The Infusion Nurse uses appropriate professional judgment and decision-making in planning and providing care. Nursing care is to be delivered in a manner consistent with the Standard Operating Procedures and standards of practice, and professional evidence-based standards. Essential Responsibilities Patient Care: Administer chemotherapy, immunotherapy, and investigational agents per protocol; perform venipuncture, IV insertion, central line management, ECG collection, and vital signs monitoring. Participant Support: Educate patients about clinical trials, procedures, drug administration, and potential side effects; prioritize patient dignity, safety, and welfare. Observation and Documentation: Assess patient well-being, document adverse events, and respond to emergencies using nursing standards. Protocol Compliance: Collaborate with the study team to complete all study-related procedures, including drug administration, labs, and ECGs. Planning and Communication: Prepare clinic supplies, maintain EHR quality standards, and communicate changes in patient status to providers. Mentorship and Collaboration: Train and mentor staff; interact positively with peers, patients, and families while respecting cultural diversity and confidentiality. Quality and Technical Skills: Provide high-standard care using nursing judgment; stay current on emergency certifications and policies. Education & Experience • High School Diploma or GED. • Licensed Registered Nurse in state of practice. • Basic Life Support (BLS) certification, and AHA certified program. • Previous experience in peripheral IV insertion and management of venous access device(s). Preferred Education and Experience: • 1 year of experience. • Oncology Certified Nurse (OCN). • Clinical Trial and oncology experience. • Experience working with Microsoft Office, including Teams, Excel and Word. • Advanced Cardiac Life Support (ACLS) Certification, an AHA certified program. Can be obtained within 90 days of hire. • ONS/ONCC Chemotherapy Immunotherapy Certificate™. Can be obtained within first year of employment. Best-in-Class Benefits and Perks We value our employees' time and efforts. Our commitment to your success is enhanced by a competitive compensation, depending on experience, and an extensive benefits package including: Comprehensive health coverage: Medical, dental, and vision insurance provided Robust retirement planning: 401(k) plan available with employer matching Financial security: Life and disability insurance for added protection Flexible financial options: Health savings and flexible spending accounts offered Well-being and work-life balance: Paid time off, flexible schedule, and remote work choices provided Plus, we work to maintain the best environment for our employees, where people can learn and grow with the company. We strive to provide a collaborative, creative environment where everyone feels encouraged to contribute to our processes, decisions, planning, and culture. More about The START Center for Cancer Research Deeply rooted in community oncology centers globally, The START Center for Cancer Research provides access to specialized preclinical and early-phase clinical trials of novel anti-cancer agents. START clinical trial sites have conducted more than a thousand early-phase clinical trials, including 43 therapies that were approved by the FDA. START represents the world's largest roster of Principal Investigators (PIs) across its eight clinical trial sites. Committed to accelerating passage from trials to treatments, START delivers hope to patients, families, and physicians around the world. Learn more at STARTresearch.com. Ready to be part of a team changing the future of cancer treatment? Join us in our mission to conquer cancer, one clinical trial at a time. Your expertise and dedication can help us bring hope and healing to patients worldwide. Please submit your application online. We are an equal opportunity employer that welcomes and encourages diversity in the workplace. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.
    $46k-67k yearly est. 9d ago
  • Np - 15528770

    Lone Peak Hospital

    Utilization review nurse job in Draper, UT

    Lone Peak Hospital, part of MountainStar Healthcare and HCA Healthcare, is seeking a motivated and skilled Advanced Practice Provider (Nurse Practitioner or Physician Assistant) to join its growing orthopedic spine surgery team. This position offers an exciting opportunity to provide comprehensive care alongside a highly experienced spine surgeon in a collaborative and supportive environment. Position Responsibilities: • Conduct clinic visits including patient evaluations, follow-ups, and post-operative appointments • Assist with surgical procedures as credentialed and appropriate • Perform inpatient rounding, admissions, and discharges • Collaborate with the surgeon and multidisciplinary care teams to ensure high-quality, patient-centered care • Provide patient education and coordinate care planning Qualifications & Requirements: • Nurse Practitioner (NP) or Physician Assistant (PA) degree from an accredited program • Current Utah licensure (or eligibility) • Orthopedic or surgical experience preferred; new graduates with strong interest in spine surgery are encouraged to apply • Excellent clinical judgment, teamwork, and communication skills Compensation & Benefits: • Competitive salary with comprehensive benefits package • Paid time off, CME allowance, 401K, and employee stock purchase options
    $42k-63k yearly est. 60d+ ago
  • PS Spv, Nursing

    The University of Utah 4.0company rating

    Utilization review nurse job in Salt Lake City, UT

    Job Summary The University of Utah Department of Pediatrics is excited to announce an immediate opening for a Nurse Supervisor at our West High School Clinic ( WHSC ) location. We are seeking an enthusiastic, creative and hard-working individual who, in collaboration with the Medical and Behavioral Directors of WHSC Clinic, and the leadership of the Division of General Pediatrics, will be responsible for assisting with planning, organizing, and directing all of West High School Clinic's clinical workflow, customer service, human resource, and financial operations to ensure quality of service and care consistent with the U Health and Department of Pediatrics standards. The WHSC Clinic offers multidisciplinary services including pediatrics, developmental pediatrics, counseling, psychiatry and addiction psychiatry services. The clinic is busy with not only recurring attendings from these specialties present but also their respective learners rotating throughout the clinic. The WHSC Clinic Nurse Supervisor will provide the primary administrative oversight of the clinic on a day-to-day basis with the Medical and Behavioral Directors physically present approximately 2-3 days/week. The Nurse Supervisor will be responsible for developing integrated workflows for the multiple specialties and cross training the team of medical assistants to be able to provide appropriate supports to all specialties. Furthermore, as the nurse presence at the clinic, the Nurse Supervisor will also be expected to triage medical questions beyond the scope of the medical assistants' practice. The ideal candidate would have leadership experience and clinical experience as an outpatient pediatric or school nurse. Spanish speaking is preferred but not required. The University of Utah offers a comprehensive benefits package including: Excellent health care coverage at affordable rates 14.2% retirement contributions that vest immediately Generous paid leave time 11 paid Holidays per year 50% tuition reduction for employee, spouse, and dependent children Flex spending accounts Free transit on most UTA services Employee discounts on a variety of products and services including cell phones & plans, entertainment, health and fitness, restaurants, retail, and travel Professional development opportunities Additional benefits information is available at ************************** Responsibilities Essential Functions 1. (15%) Works collaboratively with the West High School Clinic Medical and Behavioral Directors and General Pediatrics Division Manager to: Ensure quality of service and care are consistent with U Health and Department of Pediatrics standards; Ensure performance goals and benchmarks are met. 2. (15%) Works collaboratively with the West High School Clinic Medical and Behavioral Directors and Division Manager to: Assess clinical workflow processes to accommodate multidisciplinary specialties presence in the clinic; Asses triage-based priority scheduling system; Supervise, hire and cross train creative, positive and enthusiastic support staff; Grow and develop a functional and efficient clinic team. 3. (10%) Works alongside the WHS Medical and Behavioral Directors and General Pediatrics Division Manager to establish policies and procedures in the areas of customer service, human resources and budgetary goals that are consistent with the U Health and Department of Pediatrics standards. 4. (30%) Works collaboratively with the West High School Clinic Medical and Behavioral Directors to provide primary administrative oversight and support of the clinic on a day-to-day basis with the Medical and Behavioral Directors physically present approximately 2-3 days/week including: Triaging medical questions beyond the scope of practice of the medical assistants; Providing backup support to team members as needed; 5. (10%) Works collaboratively with West High Clinic Medical and Behavioral Directors to monitor patient volumes, quality of care, and performance of staff to identify areas for improvement and develop strategies for improvement. 6. (5%) Ensures customer satisfaction by analyzing complaints, concerns and suggestions and providing appropriate follow through. 7. (10%) Ensures competency of staff through the development and/or presentation of educational programs and through ongoing staff performance evaluations. 8. (5%) Serve as a liaison between the Department of Pediatrics, various Departments in the School of Medicine, and West High School and Salt Lake City School District leadership to ensure quality of care and age-appropriate care is being delivered. Work Environment and Level of Frequency that may be required. Nearly Continuously: Office environment. Seldom: Infectious disease, oils (there is air or skin exposure to oils or other cutting fluids). Physical Requirements and Level of Frequency that may be required. Nearly Continuously: Hearing, listening, talking. Often: Repetitive hand motion (such as typing), walking, standing, sitting. Seldom: Bending, reaching overhead. Disclaimer This job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job. Minimum Qualifications Required Current RQI Healthcare Provider eCredential through the University of Utah Health RQI system. The eCredential is to be obtained within 30 days of hire. Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the interstate compact if switching residency to State of Utah. Must maintain current Interstate Compact (multi-state) license if residency is not being changed to Utah. Two years of nursing experience or equivalency (one year of education can be substituted for two years of related work experience). This position requires a sound knowledge of nursing practice and exceptional leadership abilities. This position is patient-sensitive and must fulfill all associated requirements. We protect our patients, coworkers and community by requiring all patient-sensitive employees to be immunized according to CDC standards and hospital policy. Limited exemptions may be made for documented medical contraindications or religious beliefs that object to vaccinations. Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.
    $37k-59k yearly est. 60d+ ago
  • Travel Nurse Clinical Instructor, USA

    Nightingale College 3.7company rating

    Utilization review nurse job in Salt Lake City, UT

    ***Must be willing to travel up to 100% of the time to various locations within the US during the clinical rotations. This is not a state specific travel position; assignments can be located in any of the Nightingale SOFE areas. Please see link below for the list of all of our SOFE (Supervised On ground Field Experience locations. We have 3 semesters each year that are 16 weeks (about 3 and a half months) long and clinical rotations take place during at least 11 of these weeks.*** Travel and lodging accommodations will be provided by the organization. *** Supervised On-Ground Field Experience (SOFE) Areas (nightingale.edu) The starting budgeted salary for this position starts at $93,500. Nightingale College utilizes a faculty ladder with five levels to determine salary and position title. Nursing Education has the following levels: Instructor, Assistant Professor I, Assistant Professor II, Associate Professor, and Professor. Placement on the faculty ladder is determined at the time of an offer and is based on degree level and years of nursing academia experience. Role and Responsibilities The Assistant Professor for Nursing Education facilitates on-ground education instruction by incorporating innovative teaching methodologies, cutting-edge technologies, and other industry trends reflecting advancements in the discipline by promoting an interdisciplinary approach to advanced practice nursing education and healthcare delivery within and outside the College. The incumbent will be accountable for delivering the nursing curriculum in accordance with the Program's mission, vision, values, and purposes. The Assistant Professor will engage with learners in all aspects of the nursing education process including evaluating the potential for achievement in the program and is accountable for Nursing Education Services successful attainment of key performance indicators, program and functional outcomes, and the success of the College's mission. The Assistant Professor functions as a valued team member within the nursing faculty. Facilitates learning in the various supervised on-ground focused education (SOFE) sites, including clinical, simulation, or skills labs across the United States. Responsible for teaching and evaluating learners in the Practical Nursing, Baccalaureate and Master's Degree Nursing Programs. Monitors, engages, and maintains open communication with learners in all aspects of the nursing education process including attendance, performance, comprehension, and evaluation in accordance with course outcomes, and submits required reports according to published deadlines. Adheres to and holds learners accountable for partner facilities' expectations. Attends nursing faculty meetings, participates in committees, engages in shared decision-making, and other faculty activities as required. May be assigned to various modalities including experiential, didactic, evaluations, and NCLEX coaching based on the needs of the College. May carry additional teaching load outside of primary assignment. Participates in the successful implementation of other functional projects as they arise. Other duties as assigned. Qualifications and Education Requirements Earned Graduate degree with a major in nursing from an accredited institution supplemented by 0-1 year of relevant experience. Active, unencumbered RN or APRN license from state of residence and ability to obtain RN and NP licensure in any jurisdiction required by the College, including a valid multi-state license. Either has an earned Certified Nurse Educator (CNE) credential or commits to obtaining this certification within a one-year period. Maintains current knowledge in multiple areas of nursing practice. Two (2) years of experience in clinical nursing, within the past five (5) years. Two (2) years of experience supervising clinical education activities preferred. Maintains immunizations and certification records as required by accreditation, facility, or state board of nursing. Additional Contributions: Annual Professional Development, Service as SME, Service on Committees, and learner load will be congruent with current faculty matrix for the assigned course(s). One (1) year experience in delivery of Concept Based Nursing Education is preferred. One (1) year of distance education experience preferred. Familiarity with learning management software, Canvas preferred. Proficiency in modern technology platforms and ability to quickly adapt to various software. ***This is NOT a remote or classroom teaching role.*** ***This position requires 100% travel to help facilitate clinical teaching located on ground teaching students at the experiential learning within the US at our SOFE location. This is not a state specific travel position; assignments can be located in any of the Nightingale SOFE areas. Please see link below for the list of all of our SOFE (Supervised On ground Field Experience locations. (link for current locations).*** Supervised On-Ground Field Experience (SOFE) Areas (nightingale.edu All Full-Time position at Nightingale are required to attend new employee orientation (NCO) in person in Salt Lake City, Utah. All travel and lodging accommodations will be provided by the organization. Nightingale's commitment to diversity and inclusion is reflected both in our learners and collaborators because we believe the best outcomes for learners from underserved and diverse populations are achieved through collaborators with similar backgrounds and cultures. Nightingale College is an equal opportunity employer. Our Mission (not just words on the wall, we live it, love it, and daily contribute to it.) At Nightingale College, our Innovative Education model helps transform rural health landscapes through our blended-distance learning platform. Every person involved with Nightingale College helps to change lives of our learners, our communities and ultimately the world by adding to the quality of healthcare. We are proud to have graduated over 3,400 nurses serving communities in need. We are serious about our outcomes and have a little bit of fun getting there. The professional and personal development of our learners and our collaborators is our company's foundation. Not only do we develop strategies that promote a positive work-life integration, but we also create an environment that invites you to become an expert in your field, be it through higher education or professional development. Put simply, we elevate employment, elevate health, and elevate education. We're so happy that you've found us!
    $93.5k yearly 60d+ ago
  • Nurse Auditor 2

    Humana 4.8company rating

    Utilization review nurse job in Salt Lake City, UT

    **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

Learn more about utilization review nurse jobs

How much does a utilization review nurse earn in Salt Lake City, UT?

The average utilization review nurse in Salt Lake City, UT earns between $41,000 and $70,000 annually. This compares to the national average utilization review nurse range of $47,000 to $89,000.

Average utilization review nurse salary in Salt Lake City, UT

$54,000

What are the biggest employers of Utilization Review Nurses in Salt Lake City, UT?

The biggest employers of Utilization Review Nurses in Salt Lake City, UT are:
  1. Centerwell
  2. Utah Valley University
  3. Evolent Health
  4. University of Utah Health
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