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Utilization review nurse jobs in Utah - 124 jobs

  • Medical Review Nurse (RN)- Itemized Bill Review

    Molina Healthcare 4.4company rating

    Utilization review nurse job in Orem, UT

    Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care. ESSENTIAL JOB DUTIES: Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an appeal has been made, or is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing. Reevaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of relevant and applicable state and federal regulatory requirements and guidelines, knowledge of Molina policies and procedures, and individual judgment and experience to assess the appropriateness of services provided, length of stay, level of care, and inpatient readmissions. Validates member medical records and claims submitted/correct coding, to ensure appropriate reimbursement to providers. Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review including diagnosis-related group (DRG) validation, itemized bill review, appropriate level of care, inpatient readmission, and any opportunities identified by the payment integrity analytical team; makes decisions and recommendations pertinent to clinical experience. Prepares and presents cases representing Molina, along with the chief medical officer (CMO), for administrative law judge pre-hearings, state insurance commissions, and judicial fair hearings. Reviews medically appropriate clinical guidelines and other appropriate criteria with medical directors on denial decisions. Supplies criteria supporting all recommendations for denial or modification of payment decisions. Serves as a clinical resource for utilization management, CMOs, physicians and member/provider inquiries/appeals. Provides training and support to clinical peers. Identifies and refers members with special needs to the appropriate Molina program per applicable policies/protocols. REQUIRED QUALIFICATIONS: At least 2 years clinical nursing experience, including at least 1 year of utilization review, medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice. Experience demonstrating knowledge of ICD-10, Current Procedural Technology (CPT) coding and Healthcare Common Procedure Coding (HCPC). Experience working within applicable state, federal, and third-party regulations. Analytic, problem-solving, and decision-making skills. Organizational and time-management skills. Attention to detail. Critical-thinking and active listening skills. Common look proficiency. Effective verbal and written communication skills. Microsoft Office suite and applicable software program(s) proficiency. PREFERRED QUALIFICATIONS: Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care certifications. Nursing experience in critical care, emergency medicine, medical/surgical or pediatrics. Billing and coding experience. 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 Pay Range: $29.05 - $67.97 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $29.1-68 hourly 1d ago
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  • Utilization and Care Management Nurse

    Cambia Health 3.9company rating

    Utilization review nurse job in Utah

    Work from home within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's dedicated team of Nurses are living our mission to make health care easier and lives better. As a member of the Clinical Services team, our Utilization and Care Management Nurses provide utilization and care management (such as prospective concurrent, retrospective review, post-discharge care coordination) to best meet the member's specific healthcare needs and to promote quality and cost-effective outcomes and appropriate payment for services - all in service of making our members' health journeys easier. Are you a Nurse who has a passion for healthcare? Are you a Nurse who is ready to take your career to the next level and make a real difference in the lives of our members? Then this role may be the perfect fit. What You Bring to Cambia: Qualifications: * Associate or Bachelor's Degree in Nursing or related field * 3 years of case management, utilization management, disease management, auditing or retrospective review experience * Equivalent combination of education and experience * Must have licensure or certification, in a state or territory of the United States, in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice for the discipline (e.g. medical vs. behavioral health) and at least 3 years (or full time equivalent) of direct clinical care. * May need to have licensure in all four states served by Cambia: Idaho, Oregon, Utah, Washington. * Must have at least one of the following: Bachelor's degree (or higher) in a health or human services-related field (psychiatric RN or Masters' degree in Behavioral Health preferred for behavioral health); or Registered nurse (RN) license (must have a current unrestricted RN license for medical care management) Skills and Attributes: * Knowledge of health insurance industry trends, technology and contractual arrangements. * General computer skills (including use of Microsoft Office, Outlook, internet search). Familiarity with health care documentation systems. * Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired * Strong verbal, written and interpersonal communication and customer service skills. * Ability to interpret policies and procedures and communicate complex topics effectively. * Strong organizational and time management skills with the ability to manage workload independently. * Ability to think critically and make decisions within individual role and responsibility. What You Will Do at Cambia: * Conducts utilization management reviews (prospective, concurrent, and retrospective) to ensure medical necessity and compliance with policy and standards of care. * Participate in care management to identify and coordinate health care needs and gaps for members during the period of discharge from a facility until 30 days post discharge. * Applies clinical expertise and evidence-based criteria to make determinations and consults with physician advisors as needed. * Collaborates with interdisciplinary teams, case management, and other departments to facilitate transitions of care and resolve issues. * Serves as a resource to internal and external customers, providing accurate and timely responses to inquiries. * Identifies opportunities for improvement and participates in quality improvement efforts. * Maintains accurate and consistent documentation and prioritizes assignments to meet performance standards and corporate goals. * Protects confidentiality of sensitive documents and issues while communicating professionally with members, providers, and regulatory organizations. #LI-Remote The expected hiring range for a Utilization and Care Management Nurse is $38.00 - $41.50 an hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 10%. The current full salary range for this role is $34.60 - $56.30 an hour. About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: * Work alongside diverse teams building cutting-edge solutions to transform health care. * Earn a competitive salary and enjoy generous benefits while doing work that changes lives. * Grow your career with a company committed to helping you succeed. * Give back to your community by participating in Cambia-supported outreach programs. * Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: * Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. * Annual employer contribution to a health savings account. * Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. * Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). * Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). * Award-winning wellness programs that reward you for participation. * Employee Assistance Fund for those in need. * Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email ******************************. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
    $38-41.5 hourly Auto-Apply 5d ago
  • Utilization Management Appeals Nurse

    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 Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Humana is seeking a Part C Grievance & Appeals (G&A) Nurse who will assist in preparation of cases prior to review by the Humana G&A Medicare Medical Directors. The Nurse reviews the medical documentation, researching claims, benefits, as well as prior determinations pertinent to the appeal and provides a written summary of findings using a template for each case. The associate will be working and collaborating with Humana CIT teams, Vendors, G&A specialists, and Humana Medical Directors on submitted G&A cases. The G&A Nurse will participate in initiatives which result in improved member outcomes, operational efficiencies, and process improvement opportunities. + Case preparation of Medicare and/or Duals line of businessinvolving expedited, pre-service and post serviceappeals + Apply and implement Medicare, Medicaid,MCG, claims policy and evidence of coverage guidelines for reviews + Perform outreach to providers and/or members + Utilize multiple systems such as MHK, CGX, MRM, SRO **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action + 3 or more years of clinical experience preferably in an acute care, skilled or rehabilitation clinical setting or broad clinical nursing experience + Comprehensive knowledge of Microsoft Word, Outlook and Excel + Strong organizational and effective time management skills + Ability to work independently under general instructions and with a team **Preferred Qualifications** + Bachelor's degree (BSN) + Appeal Review Experience + Knowledge of MHK + Previous Medicare/Medicaid Experience + Previous experience in utilization management + Previous claims experience **Work-At-Home Requirements** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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 + 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 **Additional Information** + Hours are Monday-Friday 9am-6pm EST with a weekend rotation (Your 8-hour shift will fall within this timeframe) + Candidate's must also commit to working on the holidays as needed + This is a remote position, but all candidates must work in the Eastern Standard Time Zone (EST) 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: 01-21-2026 **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 ***************************************************************************
    $71.1k-97.8k yearly 3d 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** Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Conviva, a wholly-owned subsidiary of Humana, Inc., we want to help people everywhere, including our team members, lead their best lives. We support our team members to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our team members fresh perspective, new insights, and exciting opportunities to enhance their careers. At Conviva, we're seeking innovative people who want to make positive changes in their lives, the lives of our patients, and the healthcare industry as a whole. 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. **Preferred Locations:** Daytona, FL, Louisville, KY, San Antonio, TX **Use your skills to make an impact** **Role Essentials** + Active Unrestricted RN license + Possession of or ability to obtain Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work independently and within a team setting + Valid driver's license and/or dependable transportation necessary + Travel for offsite Orientation 2 to 8 weeks + Travel to offsite meetings up to 6 times a year as requested + 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 + Available for On Call weekend/holiday rotation if needed **Role Desirables** + Education: BSN or bachelor's degree in a related field + Experience with Florida Medicaid + Experience with Physical Therapy, DME, Cardiac or Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid Experience a plus + Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual **Additional Information** We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, 3 weeks paid vacation time, paid holidays, work-life balance, growth, a positive and fun culture and much more. 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 required; 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. 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: 02-18-2026 **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 4d 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. Required One year Utilization Review or Case Management experience. 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. At the discretion of department operational and patient care needs, this position is required to work rotating schedules, which may include variable hours, weekends, nights, and holidays to meet the staffing and patient care demands of a 24/7 complex health system. Regular, reliable, and punctual attendance during assigned shifts is considered an essential function of the role. Knowledge / Skills / Abilities Demonstrated availability to work variable and rotating shifts, including nights, weekends, and holidays, in a 24/7 patient care environment. 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 Color Determination, Far Vision, Listening, Near Vision, Sitting, Speaking
    $47k-62k yearly est. Auto-Apply 13d ago
  • QM Nurse Consultant

    CVS Health 4.6company rating

    Utilization review nurse job in Utah

    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. Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with clinical editing, policy and coding standards. **Fundamental Components:** Reviews documentation and evaluates potential correct coding issues based on multiple clinical policies. Considers all documented system information as well as any additional records/data presented to develop a determination or recommendation. Data gathering requires navigation through multiple system applications. Staff may be required to contact internal Aetna departments to obtain additional information. Evaluates documentation/information to determine compliance with clinical policy, regulatory, and accreditation guidelines. Accurately applies review requirements to assure case is reviewed by a practitioner with clinical expertise for the issue at hand. Commands a comprehensive knowledge of complex delegation arrangements, contracts (member and provider), clinical criteria, benefit plan structure, regulatory requirements, company policy and other processes which are required to support the review of the clinical documentation/information. Pro-actively and consistently applies the regulatory and accreditation standards to assure that activities are reviewed and processed within guidelines. Condenses complex information into a clear and precise clinical picture while working independently. Reports audit or clinical findings to appropriate staff or others in order to ensure appropriate outcome and/or follow-up for improvement as indicated. **Required Qualifications** + 3-5 years of direct care clinical experience as an RN required. + Active and unrestricted RN licensure required in candidate's state of residence. + 2 years' experience with MS Office suite applications including Excel. Strong computer skills utilizing multiple systems and applications at the same time. + Must have critical thinking skills. **Preferred Qualifications** + Experience with ICD-10, CPT coding + Experience with QNXT + Experience with QuickBase. + Experience with Cotiviti Editing/CXT **Education** + Registered Nurse with compact license + Associates Degree required, Bachelors preferred **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: 01/30/2026 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 4d ago
  • Field Nurse Practitioner - Utah County, Utah

    Advantmed 3.6company rating

    Utilization review nurse job in Provo, 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 proud of the quality care we provide members and our team is rapidly expanding to meet the demands of our growing business; we are seeking a highly skilled and compassionate certified 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 members and other at risk 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. This role is 1099 (PRN) and offers tremendous flexibility and opportunity for those who are balancing competing priorities. Learn more about our primary purpose here Follow us on LinkedIn: ****************************************** NP Responsibilities: Perform annual in-home wellness visits and risk adjustment health assessments on a population with chronic conditions; Our thorough evaluations include: a comprehensive assessment, physical examination, body system review, vital signs, review of medication history, review of current prescriptions, review of member functional status, pain management, cognitive assessment, review of the home environment, fall risk screening, social assessment, review of daily living activities, mental health screening, documentation and communication You will play a pivotal role in providing individualized quality care to the elderly population in their homes Deliver patient health education on topics such as pain management, medication, etc. Build relationships of trust with members through exceptional communication and empathy 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: Utah County, Utah Requirements NP Qualifications: Must have a valid unencumbered NP License for the state you will be working in This role requires travel within the assigned job posting county up to a maximum 55-mile radius Previous in-home risk assessment experience preferred Previous 1099 (PRN) experience is preferred but not required 3 years patient care experience preferred (primary care/adult/geriatric, EMR) May be requested to obtain additional NP licensure supported by Advantmed Access to reliable transportation that will enable you to travel to member's homes within a designated area Strong ability to work within our EMR system Ability to work independently Bilingual is a plus Benefits Advantmed offers: Competitive compensation of ~$100 per completed in-home health assessment Paid mileage Flexible work schedule Never on-call Visits ready to be scheduled immediately Appointment confirmation support Dedicated coordinator support Advanced member scheduling coverage State of art technology
    $100 hourly 8d ago
  • Regional Nurse Consultant

    Avalon Health Care Management 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 38d ago
  • Utility Coordinator

    HDR, Inc. 4.7company rating

    Utilization review nurse job in Salt Lake City, UT

    At HDR, our employee-owners are fully engaged in creating a welcoming environment where each of us is valued and respected, a place where everyone is empowered to bring their authentic selves and novel ideas to work every day. As we foster a culture of inclusion throughout our company and within our communities, we constantly ask ourselves: What is our impact on the world? Watch Our Story:' ********************************* Each and every role throughout our organization makes a difference in our ability to change the world for the better. Read further to learn how you could help make great things possible not only in your community, but around the world. We believe transportation is more than movement, it's the foundation of connected, thriving communities. As part of HDR's Transportation Business Group, you'll help shape the systems that move people and goods safely, efficiently, and sustainably. From designing resilient highways and iconic bridges to advancing transit, passenger and freight rail, aviation, federal transportation ports and marine infrastructure, your work will directly support economic vitality, public safety, sustainable and resilient communities and quality of life. We bring together planners, engineers, architects, construction management staff, environmental, strategic communications, economists, management consultants and specialists across disciplines to solve complex mobility challenges with innovation, technical excellence, and a deep understanding of community needs. Whether you're modernizing aging infrastructure or pioneering next-generation transportation solutions, your contributions will help define the future of mobility. This isn't just a job, it's a chance to lead progress, drive meaningful impact, and leave a legacy of smarter, more connected transportation networks. We are all employee-owners at HDR, which is the foundation of our collaborative culture that connects employees around the world. In the role of Utility Coordinator, we'll count on you to: * Assist with the identification, communication, and resolution of utility conflicts on Transportation/Roadway projects. * Assist with the review of Subsurface Utility Engineering (SUE) investigations, schedule, and submittals. * Be flexible in where you will perform your work (potentially work in multiple project offices), and the work you will perform each day. * Perform utility design * Work on multi-discipline transportation programs in a program management role * Perform utility records research, obtaining project utility company contacts, existing maps and plans, preparing contact ledgers and assist in utility conflict tracking reports. * Work independently, and with project teams, coordinating with utility companies and roadway engineers to meet client's needs and objectives. * Assist with and prepare client deliverables, utility exhibits, project guides, project reviews, project invoices, expense reports and project monitoring/field verification, as needed. * Apply company/client quality assurance guidelines and procedures for project documents, time and budget management. * Assist in the review and perform QA/QC of utility company agreements, plans, specifications, cost estimates and invoices submitted by utility companies to assure compliance with applicable rules, regulations, and requirements of the client. * Frequent communication, both verbal and written, between project managers, clients, and utility owners to ensure project schedules are met and are compliant with federal, state and local laws, in addition to any other regulations required by the client. * Assist with and conduct meetings, presentations, and minutes for both in person and virtual meetings. * Support Project Managers in the development of proposal elements, project scope elements, budget elements, and schedule elements. * Type, format and organize project documents, reports, specifications, and correspondence. * Create and maintain paper and electronic files. * Perform other duties, as assigned. Preferred Qualifications * A minimum of 8 years related experience * Ability to read and understand contractual documents, including but not limited to; deeds, engineering plans, sub-contractor proposals, reimbursement agreements, occupancy and use agreements, etc. * Basic understanding of real estate principles and the ability to read and understand easements, deeds, legal descriptions and general documents associated with property rights. * Proficiency in Bluebeam Revu, ArcGIS, KMZs, AutoCAD, or MicroStation * Familiarity of Transportation/Roadway/Utility industry Required Qualifications * Technical degree or a combination of education and relevant experience * A minimum of 3 years of related experience * Proficiency in Microsoft Office, specifically Word, Excel and Outlook * Ability to read and understand civil transportation engineering design plans * Ability to read and understand utility installation and adjustment plans * Position requires strong communication, both verbal and written, organization skills, attention to detail, scheduling and problem-solving skills * An attitude and commitment to being an active participant of our employee-owned culture is a must What We Believe HDR is our company. Together, we build on each other's life experiences and perspectives to make great things possible every day. This shapes our collaborative culture, encourages organizational trust and connects us closer to the clients and communities we serve. Our Commitment As employee owners, we all have a role in creating an inclusive environment where each of us is welcomed, valued, respected and empowered to bring our authentic selves to work every day. Our eight Employee Network Groups (Asian Pacific, Black, Hispanic/Latino(a), LGBTQ , People with Disabilities, Veterans, Women, Young Professionals) help create a sense of belonging and foster a supportive environment where everyone is empowered to engage and contribute. Each group has an executive sponsor and is open to all employees.
    $45k-58k yearly est. 30d ago
  • Travel Labor & Delivery Nurse - $2,394 per week

    Cure Healthcare Staffing 3.3company rating

    Utilization review nurse job in West Valley City, UT

    Cure Healthcare Staffing is seeking a travel nurse RN Labor and Delivery for a travel nursing job in West Valley City, Utah. Job Description & Requirements Specialty: Labor and Delivery Discipline: RN Duration: 13 weeks 36 hours per week Shift: 12 hours, nights Employment Type: Travel Cure Healthcare is seeking a RN - Labor & Delivery L&D for positions in West Valley City, Utah. Current Utah license and AHA BLS and ACLS required and additional certifications related to this specialty. To qualify for this travel assignment, the candidate's primary residence must be located at least 50 miles from the facility address. This shift is 3x12 Nights. Required: 2 years of recent experience in Labor & Delivery L&D. Please inquire for specific job details and confirm shift required by facility. Cure Healthcare Staffing Job ID #35491891. Pay package is based on 12 hour shifts and 36.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN:Labor & Delivery L&D,18:00:00-06:00:00 About Cure Healthcare Staffing Phone Number: Main: 512-572-6388 Website: https://curehealthcarestaffing.com/ With 20+ years of healthcare staffing experience, Cure is helping nurses and allied health professionals rediscover their love of patient care while providing healthcare facilities with the flexible staffing solutions they need.We talk to nurses and techs every day who feel overwhelmed. By empowering them with flexibility and ownership of their career, we can keep more qualified healthcare professionals in direct patient care.Patient care should always come first. That's why we went through the process to become accredited by the Joint Commission. We only accept staff that meet the Joint Commission quality criteria so we can ensure that short-term staff assignments contribute to quality care rather than detract from it.
    $61k-86k yearly est. 2d 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 4d ago
  • OR Nurse

    Surgery Partners Careers 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. 59d ago
  • Travel Labor & Delivery Nurse - $2,070 per week

    Core Medical Group 4.7company rating

    Utilization review nurse job in West Valley City, UT

    Core Medical Group is seeking a travel nurse RN Labor and Delivery for a travel nursing job in West Valley City, Utah. Job Description & Requirements Specialty: Labor and Delivery Discipline: RN Duration: 13 weeks 36 hours per week Shift: 12 hours Employment Type: Travel Client in UT seeking Registered Nurse: Labor & Delivery for the following shift(s): Nights We are looking for a healthcare professional who is ready to provide exceptional patient care in this contract/travel role. Contract/travel assignments are typically 13 weeks, with potential to extend. Help us continue our mission to connect people, improve lives, and give back to the community by joining the CoreMedical Group team. When you work with CoreMedical Group, we put you first and treat you like family, supporting you every step of the way. CoreMedical Group is one of the largest healthcare staffing agencies in the country, with travel and contract positions located across the United States. Our recruiters will help you find the perfect job, whether it's across the country or across the street. In addition to dedicated, personalized support from your recruiter, when you work with CoreMedical Group you'll receive: Access to an extensive benefits package, including day 1 health, dental, and vision insurance, employer paid life insurance, a health reimbursement account, and more! Weekly paychecks with competitive pay packages Matching 401(k) benefits to help you save for retirement Licensure assistance and reimbursement to set you up for success on your contract Travel reimbursement and dedicated housing support while on assignment Referral cash bonuses when you connect us with other clinicians CoreMedical Group also offers you a free, all-inclusive vacation each year as our way of saying "thank you" for your hard work. Join other healthcare professionals on the annual Club CoreMed retreat and you'll see why our contract and travel professionals come back to us year after year! Your career is too valuable to tackle on your own. Let CoreMedical Group help you with your healthcare journey! *Estimate of weekly payments is intended for informational purposes and includes hourly wages, as well as reimbursements for meal & incidental expenses, and housing expenses incurred on behalf of the Company. Any benefits (medical/dental/vision) are in addition to the weekly pay. Please speak with your Recruiter for additional details. Estimated payments are subject to change until formal offer of assignment is made and accepted. Core Medical Group Job ID #1347804. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN About Core Medical Group CoreMedical Group is one of the largest healthcare staffing agencies in the country. We have jobs nationwide in travel nursing, travel allied health, interim, locum tenens, and permanent placements! Join the staffing agency with Club CoreMed, the best perk in the industry - an all inclusive paid trip to a tropical resort! Benefits Weekly pay Holiday Pay Guaranteed Hours Continuing Education 401k retirement plan Pet insurance Company provided housing options Sick pay Wellness and fitness programs Mileage reimbursement Referral bonus Employee assistance programs Medical benefits Dental benefits Vision benefits Benefits start day 1 License and certification reimbursement Life insurance Discount program
    $58k-93k yearly est. 3d ago
  • Travel Labor & Delivery Nurse - $2,268 per week

    Reliable Nurse Staffing

    Utilization review nurse job in West Valley City, UT

    Reliable Nurse Staffing is seeking a travel nurse RN Labor and Delivery for a travel nursing job in West Valley, Utah. Job Description & Requirements Specialty: Labor and Delivery Discipline: RN Duration: 13 weeks 36 hours per week Shift: 12 hours, nights Employment Type: Travel Reliable Nurse Staffing Job ID #58805782. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. About Reliable Nurse Staffing Providing reliable, competent, and compassionate care to our patients and clients. Benefits Weekly pay Holiday Pay Guaranteed Hours Referral bonus Medical benefits Dental benefits Vision benefits Life insurance
    $56k-89k yearly est. 3d ago
  • Outpatient Infusion Nurse

    Serenity Mental Health Centers 3.7company rating

    Utilization review nurse job in Lehi, UT

    Job DescriptionReady to Redefine Mental Healthcare? Join Serenity. If you're looking for an opportunity to elevate patient care while also maintaining balance for yourself - you belong here. At Serenity Healthcare, we're transforming mental wellness with a modern, compassionate, and patient-centered approach. The Role: Ketamine Infusion Nurse - RN | Lehi, UT As a Ketamine Infusion Nurse, you'll deliver safe, effective treatment in a calm, supportive setting-monitoring patients, managing care, and ensuring comfort throughout. If you're passionate about patient care and skilled in infusions, we'd love to meet you! What You'll Be Doing: Safely and effectively administering Ketamine via IV Caring closely for patients during every step of the process Explaining ketamine infusion to patients and their families in a way that inspires confidence and peace Providing calm, reassuring emotional support throughout treatment Demonstrating thorough documentation Providing support to providers and patients via telehealth when not administering infusions Jumping in where needed - we're a team, and flexibility is part of the flow Who We Are: Using advanced medical devices recently released to market, Serenity Healthcare gives our patients long-term success even when other treatments have failed. With evidence-based research and proven results to support us, we help patients take back their lives with a revolutionary technological approach to healthcare. Serenity Healthcare is an equal opportunity employer - if you're qualified, you're welcome here. This position is contingent on successfully completing a criminal background check and drug screen upon hire. Requirements What You Need: Registered Nurse (RN) License - current, active and unrestricted Completion of an accredited nursing program Confident with IV placement, upkeep, and management from start to finish Solid knowledge of meds, sterile technique, and infection control Excellent communication and interpersonal skills - a focus on patient experience Flexibility and adaptability as situations require Benefits Why You'll Love Working at Serenity: Pay ranging from $33-$36 an hour based on experience Three 12-hour shifts/week with alternating Saturdays and no Sundays 1:2 Patient / Nurse Ratio in an Outpatient Clinic Excellent benefits: We cover 90% of medical, dental & vision for you and your family 401(k) - because your future deserves self-care too 10 PTO days (15 days after first year) + 10 paid holidays to rest, reset, and recharge Employee Referral Program
    $33-36 hourly 11d ago
  • Travel Labor & Delivery Nurse - $2,316 per week

    American Traveler 3.5company rating

    Utilization review nurse job in West Jordan, UT

    American Traveler is seeking a travel nurse RN Labor and Delivery for a travel nursing job in West Jordan, Utah. & Requirements Specialty: Labor and Delivery Discipline: RN Duration: 13 weeks 36 hours per week Shift: 12 hours, nights Employment Type: Travel Job Description American Traveler is seeking an experienced RN for a Labor & Delivery assignment, requiring a UT or compact RN license and strong experience in high-volume birth settings. Responsibilities Acute care hospital setting within the Labor & Delivery, Postpartum, and Recovery unit Care for laboring, postpartum, and recovering mothers and newborns Night shift, working 12-hour shifts from 1800-0630 with every other weekend required Uses Epic EMR system Transition care responsibilities for newborns High delivery volume environment Nurses provide comprehensive care including labor, delivery, postpartum, recovery, and neonatal transition Mentoring and support available for new graduates on night shifts Orientation includes 12 hours at the start of the assignment Applicants may not have been employed by any CommonSpirit, CHI, or Dignity facility within the last year Floating may be required within the designated float zone if applicable Compliance with 60-mile radius policy for UT facilities for travel eligibility Requirements Active UT or compact RN license required at time of consideration Minimum of 2 years of recent Labor & Delivery RN experience Certifications required: BLS (AHA), ACLS, NRP, STABLE, and AWHONN Intermediate Fetal Monitoring Experience in high-volume birth facilities preferred Ability to provide references from a supervisor within the last 12 months and a peer or supervisor within the last 3 years, including employment dates and rehire eligibility Copy of driver's license required Benefits High Pay and Bonuses Medical, Dental and Vision Insurance with Day 1 Options 401(k) Plan Weekly Payroll Deposit Free Online CEUs Generous Housing Allowance Travel and Licensure Reimbursements Non-taxed Per Diem and Subsidy Traveler Rewards and Discounts American Traveler Job ID #P-656768. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Labor & Delivery About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers. With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements. American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment. With our team behind you, you can relax and enjoy a rewarding travel career.
    $64k-104k yearly est. 2d ago
  • Part-Time Night Shift Nurse

    Orem Rehabilitation & Skilled Nursing

    Utilization review nurse job in Orem, UT

    at Orem Rehab & Skilled Nursing. *Flexible shift options available! Pay: $31.00 - $40.00+ (Depending on experience.) Shifts: 6 pm - 10 pm Time Type: Part-time *The Many Perks We Offer!! - *Bonus Programs! *Daily Pay options! - Get paid when you want! *Quick Career Advancement Opportunities! - We will help you rise to the top! *Flexibly Schedule options. *Career Path Development *Tuition Reimbursement Program *GET PAID TO BRING YOUR FRIENDS! Referral Bonus opportunity *Cell Phone, Movie Ticket, and other major Discounts *Medical, Dental, Life Insurance *Mentorship and Training *401(k) with Matching Contributions *Health Insurance, Dental Insurance, Vision Insurance, Life Insurance, Etc... +Plus many more! Please ask us about all of the amazing perks we offer! About The Team: We are a culturally driven facility that strives to put our employees first! It is actually our motto that "Employees Come First" here at Orem Rehab. You will hear this all the time working with our leaders. We enjoy celebrating our accomplishments on a regular basis. Here at Orem Rehab, we have a passion for learning, embrace change, and encourage growth! Our team is driven to provide exceptional service by cultivating a workforce that is dedicated to upholding our company's mission of delivering care with compassion and integrity. We value innovation and creativity in our buildings. Responsibilities: Identify patients' care requirements, focus on their needs and act on them Nurture a compassionate environment by providing psychological support Resolve or report on patients' needs or problems Prepare patients for examinations and perform routine diagnostic checks (monitor pulse, blood pressure and temperature, provide drugs and injections etc...) Monitor and record patient's condition and document provided care services Treat medical emergencies Administer workloads Follow care regulations and standards Work within and cooperate with a multidisciplinary team Job Requirements: Must have an active Utah State RN License or Utah or compact state nursing license (RN). Our Mission Statement: As a family we are focused on providing personalized quality care through hope, compassion, and dedication to excellence! Our Vision Statement: Together we grow with our community to prove quality clinical care by creating a fun, uplifting culture, with a home like environment!! We are looking for qualified RNs or LPNs to work with a great team here at our facility!! Please apply here now or contact our recruitment director for any help: James Mendenhall HR Manager Orem Rehab and Skilled Nursing Center 575 E. 1400 S. Orem, UT 84097. ********************** - Main office # ************** Work schedule Monday to Friday On call Day shift Night shift Weekend availability Supplemental pay Bonus pay Other Benefits Flexible schedule Referral program Employee discount Paid training Other
    $31-40 hourly 60d+ ago
  • Travel Labor & Delivery Nurse - $2,009 per week

    Crossmed

    Utilization review nurse job in West Valley City, UT

    CrossMed is seeking a travel nurse RN Labor and Delivery for a travel nursing job in West Valley City, Utah. Job Description & Requirements • Specialty: Labor and Delivery • Discipline: RN • 36 hours per week • Shift: 12 hours • Employment Type: Travel Job Details • Gross Weekly Pay: $1911.60 - $2008.80 • Starts: • Assignment Length: 13 Weeks • Shift: Overnight shift. • Hours Per Week: 36 • Job Quantity: 1 • Type: Travel • City: West Valley City • State: UT At CrossMed Healthcare Staffing, we aim to create lasting impressions wherever we go. Embark on your healthcare traveler journey with us and discover the CrossMed advantage. We offer competitive pay packages, comprehensive benefits, an in-house clinical team, and dedicated recruiters committed to your success. Our goal is to become the preferred staffing provider by delivering top-notch customer service. Join us and experience the difference firsthand! Benefits: • Competitive weekly pay • Insurance (Health, Dental, Vision) • Life Insurance • 401(k) • Referral Bonus • Reimbursement for Licensure & CEU's • Refer-a-Friend Bonus Program • EAP Program Qualifications: • At minimumyears' experience preferred • Graduate from an accredited school • Certifications may be required based on facility requirements • Physical abilities - remain in a stationary position, move and lift equipmentlbs), pushing, bending and pulling • Communication and collaborates with physicians and other health team members • Provides and coordinates patient care with other health team members • Monitors patients' responses to interventions and reports outcomes • Administers medications as ordered with appropriate documentation • Monitor and evaluates patients before, during, and post procedure depending on unit • Shares on-call responsibilities with a 30-minute response time if required • Maintains cleanliness of rooms and adequate stock of supplies • Transports patients as needed • Performs other duties as assigned Required Skills: • Interpersonal Skills - ability to work with diverse personnel (professional and support staff) while maintaining a positive demeanor and professional appearance. • Technical Skills - the ability to grasp, push/pull, and move while assisting with procedures or operating departmental equipment. • Cognitive Demands - capable of managing frequent interactions with the public and customers and meeting deadlines under pressure. Comfortable working under occasional close supervision or independently. • Sensory Skills - keen visual understanding and practical communication abilities. CrossMed Job ID #656762. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Labor & Delivery RN | Registered Nurse About CrossMed At CrossMed Healthcare Staffing, we aim to create lasting impressions wherever we go. Embark on your healthcare traveler journey with us and discover the CrossMed advantage. We offer competitive pay packages, comprehensive benefits, an in-house clinical team, and dedicated recruiters committed to your success. Our goal is to become the preferred staffing provider by delivering top-notch customer service. Join us and experience the difference firsthand! Benefits • Weekly pay • Holiday Pay • Guaranteed Hours • Continuing Education • Company provided housing options • Mileage reimbursement • Referral bonus • Medical benefits • Dental benefits • Vision benefits • License and certification reimbursement • Life insurance
    $1.9k-2k weekly 5d ago
  • Nursing - L&D

    Jordan Valley 3.9company rating

    Utilization review nurse job in West Valley City, UT

    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. •\tHealth, dental, vision, life, disability benefits and 401k •\tTax free stipends when applicable •\tGym discounts •\tWeekly pay •\t$750. 00 referral bonus Please apply or contract us at: www. venturamedstaff. com or ************
    $51k-62k yearly est. 6d ago
  • Triage Registered Nurse - Full Time

    Utah Navajo Health System Inc. 4.5company rating

    Utilization review nurse job in Montezuma Creek, UT

    Description We are looking for a Registered Nurse to work in our Community Health Center in Southeastern Utah. Our clinic is a dynamic place to work, practice, and grow. We have 4 primary care health centers and deliver integrated services including behavioral health, Pharmacy, Dental, specialty referrals, chronic disease management, health education, and much, much more. Filling 1 Positions Location: Montezuma Creek, Utah Full-time Benefits start at: PTO leave, Vacation leave, 14 paid Holidays, Medical Insurance for employees and dependents, Life insurance, Retirement plan, wellness benefits. Optional coverage for dental, Vision, and short/long term disability. Key Performance Indicators: Interview patient to determine medical problem/condition Address patient telephone inquiries by evaluating and responding to the patient's problems and questions. Observe patient(s) and report adverse reactions of medication or treatment to provider. Obtain patient's vital signs, pain level and weight. Screen patient for depression, changes in tobacco use, caffeine use, diet, health literacy level, preferred method of learning, and medication allergies. Collect samples, such as urine, blood, and sputum, from patients for testing and follow-up needs with patient. Dress wounds, apply hot or cold compresses as ordered. Assemble and use urinary catheters and oxygen supplies Order diagnostic procedures and labs as directed by primary care provider with verbal order read back Maintain Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Pediatric Advanced Life Support (PALS) certification at all times Attend mandatory monthly meetings Locate and attend meetings, online webinars, conferences and training that emphasize your role/responsibilities Locate articles and stay up to date on latest evidence based practice regarding your role/responsibilities Complete yearly competencies as assigned by supervisor Educate patients about immunizations verbally, and give written Vaccine Information Sheet (VIS) Educate patient about healthcare system, what to expect, how to prepare, and be self-empowered Educate patient about medication side-effects, disease, comorbidities, family planning and wellness Ensure patient understands information and instructions given by provider and inform provider if patient needs further teaching or clarification Maintain proper hand-hygiene Use personal protective equipment (PPE) according to Center for Disease Control & Prevention (CDC) recommendations Perform low-level disinfection of medical equipment, devices and supplies Properly sterilize equipment and supplies. Maintain supplies, including stocking and ordering new supplies Properly dispose of expired or damaged supplies, medical equipment and devices. Administer medications as prescribed, orally, subcutaneous, intramuscular injection, intravascular, or intraosseous and document time and amount on patient's chart. Update patients on their immunization schedule according to CDC recommendations Remove all expired medication/injectable and products in crash cart and place order with administrator or pharmacist for replacement Write prescriptions at providers request with verbal read-back of order Assist patient with scheduling appointments Follow up with patients who miss appointments. Follow up with patients on lab results, including the scheduling of any additional tests. Write referrals with verbal read back of order for patients through insurance and other physician offices and follow-up. Confirm medical records are available in patient chart before follow-up appointments Ensure that a delegated task is non-complex and personnel is adequately trained for the task before delegating a task Ensure that personnel has effectively demonstrated a delegated task as learned Ensure that personnel can perform a delegated task safely and patient is safe for personnel to carry out the task Ensure appropriate supervision is available during implementation of a delegated task Evaluate effectiveness of nursing plan of care from delegation and modify plan as needed Assign as necessary to other Registered Nurses (RNs) or Licensed Practical Nurse (LPNs), delegate to unlicensed assistive personnel [UAP (including medical assistants)] and Certified Nursing Assistants (CNAs) Complete highest priority/urgent tasks whenever possible during triage of patients Identify first level (highest priority/urgency) patient problems that may threaten patient's immediate survival or safety and respond appropriately Identify second level concerns and schedule with provider's walk-in slots, giving preference to patient primary care provider or team if available within timely manner Identify third level patient concerns and schedule patient with primary care providers next available appointment slot or within reasonable time frame according to patient care need Know the needs and priorities of each patient and reassess patient according to patient priority level as necessary Requirements Perform nursing assessment and identify pertinent information to verbalize to provider. Review and implement primary care provider orders Participate in ongoing education and training Educate patient regarding their healthcare and the healthcare system for patient/family to effectively care for patient Reduce the risk of infections Safely administer medications Perform nursing evaluation and follow-up with patient for continued comprehensive care Assign and delegate tasks appropriately when necessary and accept assignments when necessary according to Utah Nurse Practice Act Prioritize client care and schedule patient as a Triage nurse Experience, Training, and Qualifications needed to perform the job: Registered Nurse license within state of Utah Must be able to safely lift, push and pull fifty (50) pounds or more above waist Ideally 3 years experience minimum. Computer skills required to input data, experience with Microsoft office is preferred. Must have an excellent work history and customer service mindset. As a Tribal Organization the Utah Navajo Health System, Inc. (UNHS) treats patients with high risk and underlying chronic medical conditions. Therefore, UNHS requires its employees to show proof of immunization prior to their employment with UNHS or during their employment. Below is a list of immunizations/vaccinations required to be employed or to continue employment with UNHS. The immunizations/vaccinations include but not limited to following: MMR (Measles Rubeola, Mumps, Rubella): Documentation of two MMR vaccines (OR) Documentation of MMR titers. Complete Hepatitis B vaccine series (3 doses), documented proof of titers indicating immunity, or a declination that may be signed upon arrival. Proof of up-to-date PPD skin testing, if previously negative (OR) Proof of positive PPD skin test with the most recent chest x-ray and treatment history. Tetanus, diphtheria, and pertussis (Tdap). Varicella titers, history of varicella or varicella immunization series. Influenza vaccine for the current year. COVID-19 vaccine Any other vaccinations as requested. UNHS would not be able to achieve our goal of quality equitable healthcare for people living in southeastern Utah without our committed and competent staff. UNHS continually attracts the most devoted healthcare professionals and administrators this region has to offer. We are a NPEA and EEO compliant employer.
    $51k-66k yearly est. 60d+ ago

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