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  • Utilization Review Coordinator

    Universal Health Services 4.4company rating

    Utilization review nurse job in Birmingham, AL

    Responsibilities Utilization Review Coordinator- PRN The Utilization Review Coordinator reviews medical records of patients admitted for psychiatric/mental illness to ensure proper utilization of facility resources, conducts review of patient records to ensure proper case documentation and medical necessity of treatment in accordance with Federal, State, and County regulations; assesses continuing treatment plans and advocates for required patient treatment with medical providers. Serves as a financial liaison between the facility, patient/family and the payor by verifying and securing financial support/commitment for the admission. MUST HAVE availability to attend an 8- business day Orientation from 8a-4p without interruptions. Hill Crest Behavioral Health is an acute care, 194 bed inpatient psychiatric facility located in Birmingham, AL, providing mental health services for adolescents and adults. * We do not treat medically compromised individuals beyond our scope of care. * We currently treat: * Acute Adults * Acute Adolescents * Forensic Adult Males * Residential Males and Females Hill Crest Behavioral Health offers comprehensive benefits, such as: * Challenging and rewarding work environment * Competitive Compensation & Generous Paid Time Off * Excellent Medical, Dental, Vision and Prescription Drug Plans * 401(K) with company match and discounted stock plan * SoFi Student Loan Refinancing Program * Career development opportunities within UHS and its 300+ Subsidiaries! * More information is available on our Benefits Guest Website: benefits.uhsguest.com About Universal Health Services One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. *********** Qualifications REQUIRED KNOWLEDGE, SKILLS AND ABILITIES * Minimum of a Bachelor's Degree in the area of Counseling, Psychology, or Social Services related field or Nursing BSN or RN. * Strong organizational skills and excellent interpersonal and strong negotiation skills including the ability to communicate clearly and professionally both verbally and in writing * Prior experience working in a psychiatric inpatient hospital, or outpatient mental health setting, preferably in a residential or acute care * Ability to communicate and negotiate with psychiatric patients, families of patients, medical staff, ancillary staff and external agency case managers from a patient liaison position. * Computer proficiency to include word processing, spreadsheet, and data collection/management computer programs. * Strong organizational skills and excellent interpersonal and strong negotiation skills including the ability to communicate clearly and professionally both verbally and in writing Essential Job Duties/Responsibilities % Of Time 1. Coordinate with Social Services and Intake Center contacts with patient, family and referral source within twenty-four hours following admission. 15% 2. Establish scheduled communication with Review Agency to certify treatment regime, patient's need for continued treatment, and negotiate for future levels of care and extended length of stay if needed. 15% 3. Notify Business Office of any changes in benefit, rate negotiations needed, denials, etc during patient's stay. 15% 4. Coordinate information between members of the treatment team. 15% 5. Assure all admissions are reported to review agencies within their required timeframe. 15% 6. Review each case as insurance dictates for re-certification and continue with completion of the Utilization Management process as required. 10% 7. Demonstrates competence in medical knowledge and extensive knowledge and command of health insurance plans and managed care benefits. 10% 8. Performs other duties as assigned/required by this position. 5% EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Avoid and Report Recruitment Scams At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
    $55k-68k yearly est. 10d ago
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  • Patient Accommodations/Utilization Review Coordinator LPN

    DCH Health Care Authority 4.5company rating

    Utilization review nurse job in Tuscaloosa, AL

    Patient Accommodation LPN is responsible for all patient status review and related correction on discharge as needed. Under the supervision of Utilization Review Manager the LPN will review all activity sheets and physician orders to ensure all patient status requirements were met. The LPN will work closely with Patient Accommodations and Case Management. Evaluates patients for appropriateness of admission type and setting, utilizing a combination of clinical information and InterQual guidelines. The Utilization Review Nurse utilizes clinical skills to support the coordination and documentation and communication of medical services and/or benefit Administration determinations. Collect information, to render appropriate medical necessity, benefit determinations. Identify patients for referral opportunity to integrate with other product services and programs. The Utilization Nurse also serves on the liaison between the Physicians, patients, payers and Case Managers regarding termination of payment, denial notification and expedited appeals. Has access to highly sensitive, confidential information. Expected to work under minimal management supervision. Responsibilities Analyzes each of the assigned medical records for the purpose of admission and concurrent review using screening criteria. Intervenes with appropriate parties regarding inappropriate admissions, delays in discharge and the over-utilization of hospital resources. Monitors the utilization of observation services and collaborates with the Case Manger regarding correct status. Collaborates with the Case Manager to determine patient's appropriateness for acute hospital level of care. Monitors patient's clinical course to verify patients continued need for acute hospital level of care. Enter documentation into third-party system as required. Provides clinical information as necessary to obtain authorization for acute inpatient care. Refers cases not meeting acute inpatient criteria to a physician advisor and assists with his/her review of the case Works with Patient Registration/Financial Counselor(s) to identify correct insurance source and proper billing. Verifies patient admission information for each assigned patient within 24 hours of patient's admission (next business day). Collaborates with the Case Manager to identify referrals to Financial Counselors. Provides third party payers with concurrent review information as needed to comply with payers requirements for documentation of medical necessity. Document denial billing requirements in the Billing Office system. Negotiates resolution disagreements over the need for acute hospital level of care with the insurer. Collects and documents data on each admitted patient on an ongoing basis. Documents all patient status and/or observations status according to policies and procedures. Demonstrates a working knowledge of the order entry process and transcription of physician orders. Identifies Potential Avoidable Days per department policy. Gathers information for statistical monitors, plus special projects within Case Management Department. Delivers denial letters from all payers to the beneficiary or proper representative; explain appeal rights. Maintains records in a complete, detailed and orderly manner. Updates and documents in the Case Management system pertinent clinical information by utilizing screening criteria and assigns next review date. Responsible to support and participate in department strategies and efforts focused on improving length of stay (LOS). Responsible to support and participate in department strategies and efforts focused on improving clinical documentation by physicians. Is knowledgeable of hospital mission, vision, and values and performs in a manner to support them. Identifies and reports Quality and Risk Management concerns. Demonstrates Age Specific competency in managing assigned cases. Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation. Must be able to successfully complete the Interrator Reliabililty Tool for InterQual Level of Care Acute Criteria. (Adult and Pediatric) after successful orientation. DCH Standards: Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation. Performs compliance requirements as outlined in the Employee Handbook Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self. Performs essential job functions in a manner that ensures the safety of patients, visitors and employees. Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees. Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees. Requires use of electronic mail, time and attendance software, learning management software and intranet. Must adhere to all DCH Health System policies and procedures. All other duties as assigned. Qualifications Minimum of Licensed Practical Nurse with current Alabama license. Minimum 2 years experience as LPN. Minimum of 2 years of Med Surgical experience required; Utilization Review experience preferred. Efficient use of basic computer skills Ability to multi task, prioritize and effectively adapt to a fast paced changing environment Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the phone and typing on the computer. Work requires the ability to perform close inspection of computer generated documents as well as a PC monitor. Typical office working environment with productivity and quality expectations. Ability to establish priorities, meets deadlines, and maintains proper productivity. Ability to form positive, collaborative relationships with hospital staff, patients, families and payers. Ability to problem solve in a proactive, creative manner, using sound judgment based on factual information and clinical knowledge. Ability to effectively negotiate with internal and external providers of patient care services. Ability to develop leadership skills and to serve as a role model for clinical staff. Ability to lead and actively participate in multidisciplinary teams. Ability to work independently or within a team structure. Excellent interpersonal skills, communication style and organization. Must be able to read, write legibly, speak, and comprehend English. WORKING CONDITIONS Is able to lift at least 20 lbs. Ability to tolerate prolonged periods of sitting, or standing and/or walking. Ability to reach reasonable distances to handle equipment. Good manual and finger dexterity. Good communication skills Physical presence onsite is essential. Hearing and vision must be normal or corrected to within normal range. Able to perform the duties with or without reasonable accommodation.
    $52k-65k yearly est. Auto-Apply 60d+ ago
  • Manager Utilization Review/RN

    Dchsystem

    Utilization review nurse job in Tuscaloosa, AL

    Oversees the evaluation of patients for appropriateness of admission type and setting, utilizing a combination of clinical information, screening criteria and third-party information across the DCH System. Serves as the primary educator for all DCH PA's, Case Managers, Social Workers, CDI personnel, Utilization Review Coordinators (URC), in the principles of utilization management and serves as a consultant for issues regarding regulations, compliance, payor specific criteria and the denial management process for the DCH System. Responsibilities Supervises utilization review professional and clerical employees. Establishes, manages, approves, and constantly evaluates staffing levels, performance, assignments, skills, learning needs and deployment of Utilization Review. Responsible to support and participate in DCH System strategies and efforts focused on improving length of stay (LOS) and reducing readmissions. Ensures orientation and training in Utilization Review for Utilization Review Staff. Manages the day to day operations for the DCH System Commercial Utilization Review function. Displays sound managerial judgment in all areas. Supervises and initiates or recommends personnel actions for Utilization Review staff members. Manages departmental budget and productivity standards. Interviews, selects, hires, and retains employees 1 0. Performs compliance requirements as outlined in the Employee Handbook Approves payroll and is responsible for accurate payment of employees 1 2. Is knowledgeable of hospital mission, vision, and values, and performs in a manner to support them. 1 3. Manages the performance of URC t s providing feedback and direction. 1 4. Informs staff of any insurance changes involving InterQual guidelines or in providing clinical reviews. 1 5. Functions as a consultant to staff for solving challenging utilization issues throughout the DCH System. 1 6. Analyzes each of the assigned medical records for the purpose of medical necessity and appropriate billing status. Collaborates with Business Office Personnel to identify correct insurance source, initial pre-certification information and provides clinical information as necessary to obtain authorization for payment. Manages utilization of Commercial observation process. Collaborates with the Case Manager to determine patient's appropriateness for acute hospital level of care, Evaluates patient's clinical course to verify patients continued need for acute hospital level of care. Provides third party payers with clinical information as needed to comply with payers' requirements for documentation of medical necessity. Negotiates a resolution of any DCH System disagreement over the need for acute hospital level of care with the insurer. Intervenes with appropriate parties regarding inappropriate admissions, delays in discharge and the overutilization of hospital resources. Intervenes with appropriate individuals regarding delays in service that may have an impact on the quality of patient care and/or length of stay. Refers appropriately to Performance Improvement and Risk Management for patient safety occurrences and sentinel events. Refers cases not meeting acute inpatient criteria to the physician advisor and assists with his/her review of the case. Gathers information for monthly statistical reports, special projects as assigned by the Corporate Director of Case Coordination. Assists in discharge planning by confirming patient's insurance benefits. Updates and documents in the computer system pertinent clinical information by utilizing screening criteria. Maintains records in a complete, detailed and orderly manner. Identifies potentially avoidable days per department policy. Establish appropriate staffing levels, assignments, and deployment of Utilization Review staff. Collaborates with Medical Records and patient Accommodations regarding patient billing status. Collaborates with the Financial Counselors to facilitate the Medicaid application process. Manages the delivery of the denial notification for the DCH Health System. Manages work list of BC/Commercial patients with Hospital acquired conditions/Never Events. Responsible to support and participate in department strategies and efforts focused on improving length of stay (LOS). Responsible to support and participate in department strategies and efforts focused on improving clinical documentation by physicians and staff. Manages the BC/BS's Concurrent Utilization Review program (CURP) for RMC, NMC, and FMC for the DCH System. Liaison between hospital & payers during concurrent and retrospective medical necessity audits for the DCH System. Manages continuation of benefits notices issued by Physician Advisor (i.e. pt. notification business office). Conducts retrospective medical record audits to verify appropriate administration of criteria and reports findings as directed. Conducts special focused reviews as directed. Collaborates with the Compliance Officer to assure accurate billing on cases with ambiguous orders. Supports departmental operations to ensure consistency with health system/departmental policies. Provides service in the most cost-effective manner, without compromising the quality of care, or customer satisfaction. Assists Corporate Director of Care Coordination in planning and implementation of opportunities and new ideas to promote department growth and development. Designs and develops processes related to special projects as assigned by Director. Maintains, monitors, and audits accuracy of outpatient and inpatient appeals and interventions and observation according to department policies based on medical necessity. Develops a working knowledge of IMAC's, eFR, and EPSI computer software. Monitors hospital effectiveness for managing patient billing status, identifies opportunities for improvement and informs leadership through monthly reports. Manages hospital appeals for reconsideration of denied payment by insurance companies. Maintains confidentiality at all times related to both patient and employee information. Manaqer Manages departmental budget Interviews, selects, hires, and retains employees Ensures orientation and training for employees Manages performance Promotes, demotes, or transfers employees to meet organizational needs Executes employee accountability process up to and including termination Manages departmental productivity standards Performs compliance requirements Approves payroll and is responsible for accurate payment of employees Manages front line operations of area of accountability related to meeting/exceeding departmental goats DCH Standards: Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation. Performs compliance requirements as outtined in the Employee Handbook Must adhere to the DCH Mission, Vision, and Values including creating positive relationships with patients/families, coworkers, colleagues and with self. Performs essential job functions in a manner that ensures the safety of patients, visitors and employees. Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees. Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees. Requires use of electronic mail, time and attendance software, learning management software and intranet. Must adhere to all DCH Health System policies and procedures. All other duties as assigned. Qualifications Registered Nurse with current Alabama license; very good organizational and interpersonal skills required. Computer knowledge required At least three years acute hospital Utilization Review experience required Can write legibly and speak and read English. A minimum of five (5) years Utilization Review experience preferred Ability to establish priorities, meet deadlines, and maintains proper productivity. Ability to form positive, collaborative relationships with hospital staff, patients, families and post-acute providers. Ability to problem solve in a proactive, creative manner, using sound judgment based on factual information and clinical knowledge. Excellent leadership skills and to serve as a role model for staff. Ability to lead and actively participate in multidisciplinary teams. Intermediate computer skills. Ability to work independently or within a team structure. Excellent interpersonal skills and communication style. Must be able to read, write legibly, speak, and comprehend English. WORKING CONDITIONS Is able to lift at least 201bs. Ability to tolerate prolonged periods of sitting, or standing and/or walking Ability to reach reasonable distances to handle equipment Good manual and finger dexterity. Hearing and vision must be corrected to within normal range. Good communication skills. Physical presence onsite is essential. Hearing and vision must be normal or corrected to within normal range. Able to perform the duties with or without reasonable accommodation.
    $47k-63k yearly est. Auto-Apply 3d ago
  • Utility Coordinator - Atlanta

    Accura Engineering & Consulting Services 3.7company rating

    Utilization review nurse job in Birmingham, AL

    Job Title: Utility Coordinator ***Work Location: Metro Atlanta (GDOT District 7) *** Salary: Based on experience and will be discussed with manager in interview Duties/Responsibilities : Serve as a liaison between designers, utility agencies, and project owners. Conduct and document utility coordination meetings, including meeting minutes and follow-up actions. Maintain records of all utility coordination activities. Communicate status updates to project teams regarding utility coordination. Manage pre-construction utility coordination for moderate to complex Georgia Department of Transportation (GDOT) projects, including Concept, Preliminary Design, and Final Design phases. Administer utility coordination for Design-Build projects, Local Government Projects, and roadway contractors. Develop and process utility agreements, contract item agreements, and lighting agreements. Execute memorandums of understanding and conduct prior rights research. Assist with the administration of GDOT's electronic permitting program (GPASS/GUPS). Develop and provide training for GDOT Districts and State Utilities Offices. Perform analyses for complex engineering and environmental projects. Demonstrate competency in field supervision, technical knowledge, and project management. Interpret findings accurately and identify inconsistencies or inappropriate results. Provide mentorship and training to subordinate staff. Assume full responsibility for managing large tasks or projects, including strategy development, budgeting, and project deliverables. Manage and communicate results, budgets, and schedules to clients, project managers, and operations teams. Ensure compliance with company administrative, financial, and safety policies. Education/Experience: High School Diploma required, bachelor's degree preferred but not required Minimum of 7 years of transportation experience in construction inspection, design, and/or utility coordination. Strong problem-solving skills and ability to manage tasks and projects efficiently. Demonstrated experience in client relations, decision-making, and leadership. Excellent written and verbal communication skills. Ability to build and maintain effective internal and external relationships. Willingness to develop business from new and existing clients. Ability to work in an office environment with occasional field site visits for progress reviews and quality control. Benefits: Competitive salary based on experience. Comprehensive health, dental, and vision insurance. Retirement savings plan with company match. Paid time off and holidays. Professional development and career advancement opportunities. A supportive and collaborative work environment. Equal Opportunity Employer (U.S.) all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, sexual orientation, gender identity, or any other characteristic protected by law. Accura uses E-Verify in its hiring practices to achieve a lawful workplace. *******************
    $45k-57k yearly est. 41d ago
  • Float Nurse - 9 month position (3478)

    Shelby County Schools 4.6company rating

    Utilization review nurse job in Chelsea, AL

    Float Nurse PC# 3478 Qualifications: Clinical nursing experience with school age children in the hospital, community health or pediatric clinic desired. Clinical nursing skills necessary to provide safe care to students with special health care needs. Ability to communicate professionally and effectively with administration, nursing supervisor, faculty, parents and students. Ability to demonstrate complete, accurate and timely documentation of health services rendered. Possess current CPR certification. Such alternatives to the above qualifications as the Board of Education may find appropriate and acceptable. Reports to: Principal, Student Services Coordinator, Nurse Supervisor Job Goal: Provision of school health services to students and serve as a liaison between the school, the medical community and other agencies involved in the health and welfare of students. Terms of Employment: Nine month contract (187 days). Link Job Description Link Salary Schedule Additional Information: Full time, 9 month Float Nurse Position, RN required. This position requires ability to work flexible hours as needed to cover medically impacted students at school, during after-hour activities and on bus routes.
    $37k-50k yearly est. 60d+ ago
  • Reserve Nurse

    Dev 4.2company rating

    Utilization review nurse job in Birmingham, AL

    Jobs for Humanity is dedicated to building an inclusive and just employment ecosystem. Therefore, we have dedicated this job posting to individuals coming from the following communities: Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Ethnic Minority, and the Previously Incarcerated. If you identify with any of the following communities do not hesitate to register, even if you feel that this particular opportunity is not the right fit for you. Company Name: Colten Care Job Description Reserve Nurse Salary: N/A Part Time Want to travel the world and make a difference? The Army Reserve is the perfect place to start - whether you're fully trained or have already started a degree in Nursing. You'll help keep the Army running, whether that's by helping soldiers in the field, at an NHS trust or from a Medical Regiment in the UK. Wherever the British Army is, you'll find our Nurses giving first rate nursing care in all sorts of environments and situations. Reach new heights. Make a difference. As you travel the world, gaining valuable skills and civilian recognised qualifications along the way, you'll learn how to work in the most challenging environments with minimal equipment. This is your chance to achieve greatness and learn vital skills that'll set you up for life. This is your chance to do something that matters. You'll be paid on a daily rate commensurate to your qualifications. This includes being paid for weekly drill nights. Plus, if you complete all of your annual training days, you're entitled to a tax-free lump sum called a bounty. JOIN AS A REGISTERED NURSE You'll command a team that provides the highest standard of care. Army nursing can be tough, so we'll give you the best possible military and professional training. You can develop your skills throughout your career with further study up to and beyond MSc level, funded by us. It's not all hard work though. You'll also get to travel, take part in Adventure Training and play sports for the Army. With a competitive salary, non-contributory pension and free healthcare too, you'll get great rewards - and an amazing experience. Opportunities to commission as an Officer depend upon your knowledge, skills and experience. During your Army Nursing application, we will advise and support you in making the right career choice for you so that you can realise your true potential. JOIN AS A STUDENT NURSE You can join the Army Reserve as a Student Nurse, however, until you complete your Nurse training and are registered with the Nursing and Midwifery Council (NMC) you will fulfil an alternative role within the medical unit of your choice. To become an Army Reserve Nurse you'll: - Need to be registered with the National Medical Council. - Be clinically qualified, current and working in this field For more information on entry requirements Search Army Nurse. Our next deadline for application is 31st March 2023 , with further opportunities ongoing throughout the year. This is your chance to experience full-time soldier opportunities in a role that fits around your life. Are you ready for an adventure? Find where you belong.
    $35k-45k yearly est. 1d ago
  • PACU Nurse - Alabama Anesthesiology & Pain Consultants

    Resolve Pain Solutions

    Utilization review nurse job in Pell City, AL

    Alabama Anesthesiology & Pain Consultants (AAPC) is seeking a skilled and compassionate PACU Nurse to join our Ambulatory Surgery Center team in Pell City, AL. If you're dedicated to delivering exceptional post-anesthesia care and thrive in a fast-paced, patient-focused environment-with no nights, weekends, or call-this is the role for you. About the Role As a PACU Nurse at AAPC, you will provide high-quality post-anesthesia care to patients recovering from interventional pain and outpatient procedures. You will play a vital role in patient safety, comfort, and recovery while collaborating with physicians, anesthesia providers, and clinical staff to ensure seamless, compassionate care. Key Responsibilities Patient Recovery & Monitoring Receive patients from the procedure suite and perform immediate post-anesthesia assessments. Monitor vital signs, airway, pain level, and surgical sites throughout recovery. Administer medications, fluids, and oxygen per provider orders. Recognize and respond to complications or changes in patient condition. Ensure all clinical discharge criteria are safely met. Patient & Family Communication Provide supportive, compassionate care during recovery. Educate patients and families on post-procedure care and medications. Verify understanding and document all discharge teaching. Clinical Documentation & Compliance Accurately document assessments, interventions, and medications in the EMR. Maintain compliance with HIPAA, OSHA, state/federal regulations, and accrediting standards. Participate in safety huddles and quality initiatives. Team Collaboration Communicate effectively with anesthesia providers, physicians, and pre-op staff for smooth care transitions. Help maintain PACU supplies and equipment. Contribute to continuous quality improvement and a positive team culture. Qualifications Education & Licensure Graduate of an accredited School of Nursing (BSN preferred). Active RN license in the State of Alabama. Current BLS and ACLS certifications (required). Experience Minimum 2 years of nursing experience required. At least 1 year of PACU, ICU, or ED experience strongly preferred. Ambulatory surgery center or interventional pain experience is a plus. Skills & Competencies Strong clinical assessment and post-anesthesia care capabilities. Excellent communication and patient education skills. Proficiency with EMR systems. Commitment to patient-centered care, safety, and confidentiality. Physical Requirements Ability to stand, walk, and assist patients for extended periods. Ability to lift and position patients/equipment as needed. Must be able to respond quickly in emergency situations. Schedule & Benefits Full-time, Monday-Friday (daytime hours) No weekends, holidays, or on-call Enjoy a stable, supportive work environment focused on teamwork and patient care.
    $52k-72k yearly est. Auto-Apply 45d ago
  • Treatment Nurse (RN or LPN)

    East Glen

    Utilization review nurse job in Birmingham, AL

    Provide primary skin care to residents under the medical direction and supervision of the residents' attending physicians, the Director of Nursing, or the Medical Director of the facility, with emphasis on treatment and therapy of skin disorders. Assist in modifying the treatment regimen to meet the physical and psychosocial needs of the resident, in accordance with established medical practices and the requirements of the state and the policies and goals of the Facility. Essential Job Functions Confer with the Director of Nursing Services/Clinical Services Administrator and/or other licensed nursing personnel regarding dermatologic disorders of residents in the facility. Consult with the Care Planning Team concerning assessment evaluations and assist in planning and developing the skin care treatment to be performed for the resident. Initiate requests for consultation or referral. Respond to requests from the resident, physician, or nursing staff. Examine the resident and his/her records and charts, and discriminate between normal and abnormal findings, in order to recognize when to refer the resident to a physician for evaluation, supervision, or directions. Complete medical forms, reports, evaluations, studies and charting. Make written and oral reports/recommendations to the attending physician, Medical Director, or the Director of Nursing Services/Clinical Services Administrator concerning the status and care of the residents. Work with the Interdisciplinary Care Plan Team in developing a comprehensive assessment and care plan for assigned residents. Provide written and/or oral status reports of residents receiving treatment. Evaluate and implement recommendations from established committees as they may pertain to the medical activities of the facility and the skin care of residents. Provide direct patient care upon request of supervisor or as required in order to meet the needs of resident. Maintain an effective, friendly working relationship with health professionals, physicians, consultants, and family members involved. Direct the functions of the Certified Nursing Assistants in accordance with the resident care plan, current rules, regulations, and guidelines that govern the long term care facility. Identify, manage, and treat specific skin disorders and primary and secondary lesions, such as skin abrasions, foot problems such as corns and calluses, decubitus ulcers, bacterial, parasitic and viral skin infections, scaling popular diseases, and benign tumors. Provide assessment and diagnostic services to residents. Perform an assessment evaluation using techniques including observation, inspection, and palpation. Complete a quarterly physical dermatologic examination of the resident and record the results with the assessment. Ensure that residents with decubitus ulcers receive appropriate prophylaxis and treatment, such as daily inspection, turning and activity, a well-planned diet, and maintaining a clean, dry bed. Give direct physical and psychological nursing care in emergencies, as well as in the presence of illness or disability in order to maintain life, provide comfort, reduce stress, and enhance the resident's ability to cope. Assist in the admission or discharge of residents. Provide preventive health care services. Make recommendations to the resident concerning nutrition, prevention of common skin disorders, etc. Assist in monitoring the inventory of medications, medical supplies, and equipment to ensure an adequate supply of skin care products are on hand to meet the needs of residents. Perform other duties and responsibilities as directed by supervisor including special projects. Education and Experience Must have successfully completed an accredited Registered Nurse or Licensed Practical Nurse program and be currently licensed as a nurse by the State of Alabama. Must have a minimum of one (1) year nursing experience. Training in rehabilitative and skin therapy practices preferred. Physical Requirements for Essential Job Functions Must be able to move about intermittently throughout the workday. Must be able to cope with the mental and emotional stress of the position. Must be able to reach, bend, and/or stoop intermittently throughout the work day. Must be able to see and hear or use prosthetics that will enable these senses to function adequately to ensure that the requirements of this position can be fully met. Must be able to push, pull, or move a minimum of 100 pounds utilizing proper body mechanics and assistance. Must be able to walk/stand 75% of the day.
    $30k-50k yearly est. 8d ago
  • MedSurg- Nurse

    Insight Global

    Utilization review nurse job in Birmingham, AL

    To utilize the nursing process to care and/or counsel individuals in the promotion and maintenance of health and the prevention of illness and injury. Using a systematic critical-thinking approach to guide data gathering, assessment, nursing judgment, intervention and evaluation of human responses to actual and potential health problems through activities such as health teaching, health counseling and the provision of care supportive and restorative of life and supportive of a peaceful death. To identify patient needs using the American Association of Critical Care Nurses (AACN) Synergy Model. To delegate, coordinate and manage all aspects of nursing care provided to the patient, their family and our community in a timely and cost-effective manner. To deliver patient care in collaboration with the patient, their family and all members of the health care team and with the knowledge of a licensed physician, psychologist, podiatrist, and/or dentist. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ********************.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: **************************************************** Skills and Requirements * Must have RN Degree * Licenses in Alabama or Compact * BLS/CPR Certified * ACLS Certified * 2 years of experience * Travel experience * Understanding of Cardiac care
    $30k-50k yearly est. 60d+ ago
  • Treatment Nurse

    Birmingham Nursing and Rehabilitation Center East, LLC

    Utilization review nurse job in Birmingham, AL

    General Description: The Treatment Nurse is responsible for the skin and wound care of residents with an emphasis on prevention and treatment of skin disorders. The Treatment Nurse follows the established nursing Care Plan and makes appropriate adjustments as resident care needs and/or physician orders change. Assists with the duties of the staff RN, LPN or certified nursing assistants when needed. Essential Duties: 1. Identifies, plans, implements, and evaluates skin care in residents. 2. Identifies, manages, and treats specific skin disorders. 3. Performs evaluation using observation and inspection techniques. 4. Confers with the Care Planning Team in the development of the Care Plan. 5. Provides and documents, including staging and treatment of skin disorders within established wound care protocol and monitors ongoing skin and wound treatments. 6. Monitors the use of preventive measures such as inspection, turning and positioning. 7. Assists in modifying the treatment regimen to meet the needs of the resident, in accordance with established medical practices, the regulatory guidelines and the policies and goals of the Facility. 8. Provides information to resident and caregivers on prevention techniques and other ways to maintain or improve the general health and psychosocial status of the resident
    $30k-50k yearly est. 60d+ ago
  • Infusion Nurse

    Soleo Health 3.9company rating

    Utilization review nurse job in Birmingham, AL

    Soleo Health is seeking a Full-time Infusion Nurse to support our Infusion patients in the Birmingham, AL and surrounding areas. Join us in Simplifying Complex Care! Soleo Health Perks: Competitive Wages Mileage Reimbursement & Paid Drive Time 401(k) with a Match Referral Bonus Paid Time Off Great Company Culture Annual Merit Based Increases Paid Parental Leave Options Affordable Medical, Dental, & Vision Insurance Plans Company Paid Disability & Basic Life Insurance HSA & FSA (including dependent care) Options Education Assistance Program The Position: The Infusion Nurse provides primary patient care for specifically assigned patients to include assessments, care planning, evaluation and education of patients receiving infusion therapy and/or other nursing services in accordance with the care matrices and best practices in the home or alternate site setting. Responsibilities include: Provide the direct care for all assigned patients including initiation and maintenance of all communications with appropriate care team members including pharmacists, prescribers, dietitians, home patient representatives/care partner and any appropriate community resource staff members. Evaluate and education patient/care partner to safely administer the home infusion therapy and provide additional instruction as indicated. Evaluate the home environment where the care is to be provided and identify interventions that may be required to render the home care environment safe and appropriate for the prescribed care. Develop in conjunction with other team members the plan of care and evaluate response to therapy with each encounter. Develop and maintain caseload scheduling via company approved platform per company policy. Communicate any scheduling changes on an as needed basis to appropriate team members. Coordinate care via approved company platform Takes part in the nurse on-call rotation to ensure continuous nursing support services to our customers. Document all communications at time of service as appropriate per Soleo policy. Strong knowledge of therapies provided by Soleo. Work in conjunction with appropriate departments to ensure all required patient documents are completed and returned to the branch office within acceptable timeframe. Ensures timely submission of plan of treatments as required by states guideline. Schedule: Must be able to work full-time, Monday-Friday 8:30am-5pm, 40 hours per week Must be able to participate in an on-call rotation every 7th weekend Must be knowledgeable of IV access devices to include: IV lines, ports, and administration of infusion medications Must be able to provide infusions to patients in their homes as well as the infusion suite Must be able to drive up to 2 hours as needed to see patients (we offer mileage reimbursement and hourly rate of pay) Requirements RN Degree, BSN Preferred Advanced certification in specialty areas of practice (e.g., CRNI, ONS, IgRN) preferred but not required. On-Call Requirement: This position requires participation in an on-call rotation, nights and weekends included, providing as-needed support outside of regular business hours to address urgent issues and ensure continuous operations. When on call Administrative Oversight: Responsible for providing administrative oversight, including monitoring of workflows, ensuring compliance with policies, and managing resources efficiently to meet organizational objectives. Emergency Availability: Must be available to respond promptly to emergencies, ensuring rapid and effective resolution of issues to minimize impact on operations. Availability during non-standard hours, including nights, weekends, and holidays, as required by the nature of the emergency. When on call Minimum 3 years nursing experience with background in infusion therapy preferred. Current nursing license for applicable home state Experience in ICU and/or Cardiac Care preferred. Proficient with Microsoft Outlook and Microsoft Office Suite. Valid state issued driver's license with no significant restrictions on that license. About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference! Soleo's Core Values: Improve patients' lives every day Be passionate in everything you do Encourage unlimited ideas and creative thinking Make decisions as if you own the company Do the right thing Have fun! Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture. Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor. Keywords: Nursing, clinic, clinical, IV, patient care, CPR, Acute, outpatient, pharmacy, Emergency room, ICU, home care, internal medicine, GI, neuro, rheumatology, adult, registered nurse, PACU, chronic, home health, Hospice, Acute Care, Critical Care, CRNI, ER, blood products, IVIG, Biologics, TPN, step down, now hiring, hiring now, immediately hiring, hiring immediately, Vascular Access Nurse, Infusion, Specialty Infusion Pharmacy, IV Therapy, IV Infusion, Home Infusion, IV Therapy Administration, Home Infusion Therapy, Specialty Infusion Nursing, Specialty Infusion, RN Clinical Liaison, Infusion Nurse Liaison, CPR+, Alayacare
    $34k-47k yearly est. 29d ago
  • Night Shift Cart Nurse (LPN) - 7p - 7a

    Ball Healthcare 4.3company rating

    Utilization review nurse job in Birmingham, AL

    Night Shift Cart Nurse - 7p - 7a The Arlington Rehabilitation & HealthCare Center, in Birmingham, AL is currently seeking Licensed Practical Nurses (LPN) to join our team as a Cart Nurse. Minimum Qualifications: Must be a Licensed Practical Nurse (LPN) in good standing and currently licensed by the state of Alabama Must be knowledgeable of nursing and medical practices and procedures and laws, regulations and guidelines Must be able to communicate effectively, both verbally and in writing Must have a comfort and positive attitude in communicating with the elderly who have multiple nursing care needs Job Type: 12-hour shifts, 7p - 7a with Shift Differential Pay! Outstanding Comprehensive Benefits Package! Competitive Pay 401(k) Plan with Matching Funds Medical, Dental, & Vision Coverage Full Suite of Voluntary Coverage Plans Continuing Education Tuition Reimbursement Program Interested in joining our team, email your resume or apply in person at: Arlington Rehabilitation & HealthCare Center 1020 Tuscaloosa Ave. SW Birmingham, AL 35211 - Phone: ************** Arlington Rehabilitation & HealthCare Center is an Equal Opportunity Employer
    $30k-44k yearly est. 10d ago
  • Graduate Nurse - CVICU Fulltime Nights

    Orlando Health 4.8company rating

    Utilization review nurse job in Homewood, AL

    Attention new nursing school graduates! Baptist Health Brookwood Hospital is looking for a Graduate Nurse to work in our CVICU. This is a full-time opportunity working nights. If you are interested in working critical care with a great team that will help you to hone your skills, we would love to hear from you! About our Hospital Baptist Health Brookwood Hospital is a 595-bed comprehensive healthcare facility known for providing a wide range of medical services and specialized care to the Homewood community and beyond. Our dedicated team of physicians, nurses, clinicians and medical professionals are committed to delivering quality and compassionate care. Accredited by The Joint Commission, Baptist Health Brookwood Hospital is recognized for excellence in stroke care, cardiovascular services, rehabilitation, bariatrics, surgical care including minimally invasive procedures and is one of the largest providers of psychiatry care in the state. We have earned Primary Stroke Center certification from The Joint Commission and Get with the Guidelines Gold Plus Achievement in Stroke from the American Heart Association. Baptist Health Brookwood Hospital offers great NEW competitive pay and benefits! Medical, Dental, Vision 403(b) Retirement Savings Plan Health Savings Account (HSA) Flexible Spending Account (FSA) Paid Time Off (up to 5 weeks to start) Life Insurance Extended Leave Plan (ELP) Family Care (childcare, elder care, pet care) Paid Parental Leave Pet Insurance Car Insurance Educational Benefits including tuition reimbursement & monthly payments to help pay down any graduated school debt ALL benefits start on day one! Responsibilities Administers bedside patient care in a hospital or inpatient/observation setting under the supervision of a preceptor, leader, and/or charge nurse. Assesses patients' needs and develops/revises individualized plans of care based on their needs and responses. Evaluates patients' progress toward attaining expected outcomes. Respects diversity by building respectful relationships with all team members and customers. Functions as an advocate for patients and their families. Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on their assigned unit/ department. Serves as a preceptor, charge nurse, unit educator, and/ or nurse clinician. Communicates and collaborates with medical staff and the interdisciplinary team to effectively plan and manage the unit/department. Serves as a role model for staff and supports the hospital and nursing department's goals and strategies. Demonstrates knowledge of the principles of growth and development over the life span, assesses data reflective of the patient's status, and interprets the necessary information to identify each patient's requirements relative to their age- specific needs. Coordinates patient care for a defined group and delegates tasks appropriately to team members. Documents patient care in a knowledgeable, skillful, and consistent manner, meeting all required and regulatory standards. This includes, but is not limited to, patient assessment, education, medication administration, treatments, and patient safety. Demonstrates competency in nursing skills and the use of patient care/unit equipment as defined by unit/department-specific requisite skills. Prioritizes patient care in an ongoing manner in accordance with Evidence-Based Practice Standards of Care. Practices effective problem identification and resolution. Delegates tasks and duties to healthcare team members in accordance with the patient's needs and the team member's capabilities and qualifications. Communicates appropriate information regarding patient condition or unit concerns to other healthcare team members. Demonstrates caring practices by providing a compassionate and therapeutic environment for patients and their families. Demonstrates awareness of legal issues and patients' rights. Collaborates with the education department and nursing leadership team to effectively transition and support new team members and/or students. Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA, and other federal, state, and local standards. Maintains compliance with all Baptist Health policies and procedures. Qualifications Education/Training Graduate of an accredited school of nursing. Authorized by the Alabama Board of Nursing (BON) to practice as a graduate nurse and has received a “Graduate Nurse” letter. Authorized to take the NCLEX by the examination vendor. Meets all mandatory, developmental, and performance competency requirements for Baptist Health and the unit/department. Licensure/Certification Must obtain Licensure as a Registered Nurse in the State of Alabama or Nurse Licensure Compact (NLC) multistate RN license within three (3) months of placement in this job. Maintains current BLS/Healthcare Provider certification. Experience No previous experience required
    $40k-53k yearly est. Auto-Apply 29d ago
  • Nurse (Registered Nurse) 30% Recruitment Incentive - Direct Hire

    Department of Justice

    Utilization review nurse job in Talladega, AL

    Corrections professionals who foster a humane and secure environment and ensure public safety by preparing individuals for successful reentry into our communities. Corrections professionals who foster a humane and secure environment and ensure public safety by preparing individuals for successful reentry into our communities. Overview Help Accepting applications Open & closing dates 10/01/2025 to 09/30/2026 Salary $49,739 to - $113,441 per year Pay scale & grade GL 05 - 10 Locations Many vacancies in the following locations: Aliceville, AL Maxwell AFB, AL Talladega, AL Forrest City, AR Show morefewer locations (90) Phoenix, AZ Safford, AZ Tucson, AZ Atwater, CA Herlong Sierra Ordnance Depot, CA Lompoc, CA Los Angeles, CA Mendota, CA San Diego, CA Victorville, CA Florence, CO Littleton, CO Danbury, CT Coleman, FL Marianna, FL Miami, FL Miami-Dade County, FL Tallahassee, FL Atlanta, GA Jesup, GA Honolulu, HI Chicago, IL Greenville, IL Marion, IL Pekin, IL Thomson, IL Terre Haute, IN Leavenworth, KS Ashland, KY Inez, KY Lexington, KY Manchester, KY Pine Knot, KY Oakdale, LA Pollock, LA Fort Devens, MA Cumberland, MD Milan, MI Duluth, MN Rochester, MN Sandstone, MN Waseca, MN Springfield, MO Yazoo City, MS Butner Federal Correctional Complex, NC Berlin, NH Fairton, NJ Fort Dix, NJ Kings, NY Otisville, NY Ray Brook, NY Elkton, OH El Reno, OK Oklahoma City, OK Sheridan, OR Gregg Township, PA Kelly Township, PA Lewis Run, PA Loretto, PA Minersville, PA Philadelphia, PA Waymart, PA Guaynabo, PR Bennettsville, SC Edgefield, SC Estill, SC Salters, SC Yankton, SD Memphis, TN Bastrop, TX Beaumont, TX Big Spring, TX Bryan, TX Federal Medical Center Carswell, TX Fort Worth, TX Houston, TX La Tuna, TX Seagoville, TX Texarkana, TX Three Rivers, TX Jonesville, VA Prince George, VA Seatac, WA Grand Marsh, WI Alderson, WV Beaver, WV Bruceton Mills, WV Glenville, WV Morgantown, WV Welch, WV Remote job No Telework eligible No Travel Required Occasional travel - Travel may be required for training and/or work related issues. Relocation expenses reimbursed No Appointment type Permanent Work schedule Full-time - Registered Nurse Accelerated Promotion Program covers the 0610 series ranging from GL-05 through GL-10 grade levels. If eligible, this enables a Registered Nurse to promote up to twice at an accelerated pace through a training program. Service Competitive Promotion potential 10 - Grade 10 - Registered Nurse Accelerated Promotion Program covers the 0610 series ranging from GL-05 through GL-10 grade levels. If eligible, this enables a Registered Nurse to promote up to twice at an accelerated pace through a training program. Job family (Series) * 0610 Nurse Supervisory status No Security clearance Other Drug test Yes Bargaining unit status No Announcement number DHA-2026-0002 Control number 847130700 This job is open to Help The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Career transition (CTAP, ICTAP, RPL) Federal employees whose job, agency or department was eliminated and are eligible for priority over other applicants. Clarification from the agency This is a public notice under the Direct Hiring Authority open to all U.S. citizens. Please review instructions in the "
    $30k-50k yearly est. 60d+ ago
  • Utilization Review Care Manager, RN

    Dchsystem

    Utilization review nurse job in Tuscaloosa, AL

    Evaluates patients for appropriateness of admission type and setting, utilizing a combination of clinical information, medical necessity standards, and/or and InterQual guidelines. The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the liaison between the physicians, patients, payers and care managers regarding termination of benefits, denial notification, and expedited appeals. Has access to highly sensitive, confidential information. Responsibilities Evaluates medical records for appropriateness of admission status utilizing a combination of clinical information, screening criteria, and third party information. Collaborates with business office, care managers, attending physicians, and physician advisors as needed. Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and proper billing. Verifies patient admission information for each assigned patient within 24 hours of patient's admission (next business day) or per payer guidelines. Collaborates with the Case Manager to identify referrals to Financial Counselors. Negotiates resolution of disagreements over the need for acute hospital level of care with the insurer. Educates staff and physicians about managed care principles, observation status, and reimbursement rules. Maintains records in a complete, detailed, and orderly manner. Identifies Potential Avoidable Days per department policy. Conducts self-auditing of medical records for status accuracy and provides peer consultation regarding cases in which patients are failing to progress and/or experiencing significant deviation from the plan of care. Collaborates with case managers and social workers for patients with complex, clinical, financial and psycho-social needs. Reviews physician orders and patient progression and intervenes with care coordination as needed. Collaborates with other departments to eliminate barriers, as necessary. Builds trusting relationships with attending physician, patient and/or family and other members of the healthcare team. Establishes a caring relationship with patients and their caregivers, promotes patient engagement and guides patients/families through the transition phase Gathers information for statistical monitors, plus special projects within the Care Management Department. Updates and documents in Expanse and Cortex, pertinent clinical information by utilizing screening criteria and assigns next review date. Responsible to support and participate in department strategies and efforts focused on improving length of stay (LOS) and reduction of avoidable readmissions. Responsible to support and participate in department strategies and efforts focused on improving clinical documentation by physicians. Identifies and reports Quality and Risk Management concerns and enters risk events in Midas. Is knowledgeable of hospital mission, vision, and values and performs in a manner to support them. Reviews an average of 25 patients per day. Delivers denial letters from all payers to the beneficiary or proper representative; explain appeal rights. Must be able to successfully complete the Interrater Reliability Tool for InterQual Level of Care Acute Criteria. (Adult and Pediatric) after successful orientation. DCH Standards Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation. Performs compliance requirements as outlined in the Employee Handbook Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self. Requires use of electronic mail, time and attendance software, learning management software, and intranet. Must adhere to all DCH Health System policies and procedures. All other duties as assigned. Qualifications Anyone hired after July, 2011 must meet the following: Minimum of Registered Nurse with current Alabama license. Minimum 2 years experience as an RN preferred. Minimum of at least 2 years as care management and/or utilization management experience preferred. Minimum of 2 years of Med Surgical experience preferred; Utilization Review experience preferred. Expected to work under minimal management supervision Efficient use of basic computer skills Ability to multi task, prioritize and effectively adapt to a fast paced changing environment Sedentary work involving periods of sitting, talking, and listening. Work requires sitting for extended periods, talking on the phone, and typing on the computer. Work requires the ability to perform close inspection of computer generated documents as well as a PC monitor. Typical office working environment with productivity and quality expectations. Ability to establish priorities, meet deadlines, and maintain proper productivity. Ability to form positive, collaborative relationships with hospital staff, patients, families, and payers. Ability to problem solve in a proactive, creative manner, using sound judgment based on factual information and clinical knowledge. Ability to effectively negotiate with internal and external providers of patient care services. Ability to develop leadership skills and to serve as a role model for clinical staff. Ability to actively participate in multidisciplinary teams. Ability to work independently or within a team structure. Excellent interpersonal skills, communication style, and organization. Must be able to read, write legibly, speak, and comprehend English. WORK CONTEXT Ability to form positive, collaborative relationships with physicians, colleagues, hospital staff, patients, families, and external contacts. Ability to provide guidance and direction to subordinates, including performance standards and monitoring performance. Ability to encourage and build mutual trust, respect, and cooperation among team members. Ability to communicate with people outside the organization and represent the organization to the public, government, and other external sources. Ability to work independently or within a team structure. May be exposed to environmental cleaning chemicals PHYSICAL FACTORS Requires Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work. Ability to tolerate prolonged periods of sitting or standing and/or walking. Ability to reach reasonable distances to handle equipment. Good manual and finger dexterity. Must be able to perform the duties with or without reasonable accommodation. Hearing and vision must be normal or corrected to within normal range. Physical presence onsite is essential.
    $47k-63k yearly est. Auto-Apply 3d ago
  • Nurse

    Dev 4.2company rating

    Utilization review nurse job in Birmingham, AL

    Jobs for Humanity is dedicated to building an inclusive and just employment ecosystem. Therefore, we have dedicated this job posting to individuals coming from the following communities: Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Ethnic Minority, and the Previously Incarcerated. If you identify with any of the following communities do not hesitate to register, even if you feel that this particular opportunity is not the right fit for you. Company Name: Colten Care Job Description Nurse Adult Nurse Full-Time Want to travel the world and make a difference? The Army is the perfect place to start - whether you're fully trained, have already started a degree in Nursing or want to apply as a Student Nurse. As an Army Nurse, you'll help keep the Army running, whether that's by helping soldiers in the field, at an NHS trust or from a Medical Regiment in the UK. Wherever the British Army is, you'll find our Nurses giving first rate nursing care in all sorts of environments and situations. As you travel the world, gaining valuable skills and civilian recognised qualifications along the way, you'll learn how to work in the most challenging environments with minimal equipment. This is your chance to reach heights you never knew existed and learn vital skills that'll set you up for life. This is your chance to do something that matters. Find where you belong. JOIN AS A REGISTERED NURSE As a Registered Nurse, you'll command a team that provides the highest standard of care. Army nursing can be tough, so we'll give you the best possible military and professional training. You can develop your skills throughout your career with further study up to and beyond MSc level, funded by us. It's not all hard work though. You'll also get to travel, take part in Adventure Training and play sports for the Army. With a competitive salary, non-contributory pension and free healthcare too, you'll get great rewards - and an amazing experience. Opportunities to commission as an Officer depend upon your knowledge, skills and experience. During your Army Nursing application we will advise and support you in making the right career choice for you so that you can realise your true potential. GOLDEN HELLO If you hold a recognised specialist qualification within Emergency, Intensive Care, Theatres or Burns & Plastics you may be eligible for a £20,000 bonus on completion of your military training. GAIN QUALIFICATIONS The Army can help you gain a range of qualifications. These could include: Supporting Learning and Assessment in Practice (SLAiP) You will have the opportunity to specialise in: Primary Health Care (to Advanced Practice) Emergency Nursing, Critical Care Burns & Plastics, Trauma & Orthopedics Sexual Health General Medicine General Surgery. SALARY & BENEFITS - Earn a starting salary of £15,671 if joining as a solider, which will rise to over £32,076 after training - Earn a starting salary of £26,903 if joining as an officer, which will rise to over £35,744 after training - 38 days' paid annual leave - Receive subsidised accommodation and facilities, increasing your disposable income - Non-contributory pension, free medical and dental health cover - Have the continuous access to promotional opportunity and to continually progress your career - Be sponsored to earn valuable civilian-recognised qualifications - Take part in Adventurous Training and be able to play your favourite sports. ENTRY REQUIREMENTS Adult Nurse: You need to be registered with the Nursing and Midwifery Council. You can join as a newly qualified nurse, be in your final year of training (on a course which will result in Nursing and Midwifery Council registration) or join with prior nursing experience. For more information on entry requirements Search Army Nurse. Our next deadline for application is 31st March 2023, with further opportunities ongoing throughout the year. FIND WHERE YOU BELONG >
    $35k-45k yearly est. 1d ago
  • PACU Nurse - Alabama Anesthesiology & Pain Consultants

    Resolve Pain Solutions

    Utilization review nurse job in Pell City, AL

    Job Description Alabama Anesthesiology & Pain Consultants (AAPC) is seeking a skilled and compassionate PACU Nurse to join our Ambulatory Surgery Center team in Pell City, AL. If you're dedicated to delivering exceptional post-anesthesia care and thrive in a fast-paced, patient-focused environment-with no nights, weekends, or call-this is the role for you. About the Role As a PACU Nurse at AAPC, you will provide high-quality post-anesthesia care to patients recovering from interventional pain and outpatient procedures. You will play a vital role in patient safety, comfort, and recovery while collaborating with physicians, anesthesia providers, and clinical staff to ensure seamless, compassionate care. Key Responsibilities Patient Recovery & Monitoring Receive patients from the procedure suite and perform immediate post-anesthesia assessments. Monitor vital signs, airway, pain level, and surgical sites throughout recovery. Administer medications, fluids, and oxygen per provider orders. Recognize and respond to complications or changes in patient condition. Ensure all clinical discharge criteria are safely met. Patient & Family Communication Provide supportive, compassionate care during recovery. Educate patients and families on post-procedure care and medications. Verify understanding and document all discharge teaching. Clinical Documentation & Compliance Accurately document assessments, interventions, and medications in the EMR. Maintain compliance with HIPAA, OSHA, state/federal regulations, and accrediting standards. Participate in safety huddles and quality initiatives. Team Collaboration Communicate effectively with anesthesia providers, physicians, and pre-op staff for smooth care transitions. Help maintain PACU supplies and equipment. Contribute to continuous quality improvement and a positive team culture. Qualifications Education & Licensure Graduate of an accredited School of Nursing (BSN preferred). Active RN license in the State of Alabama. Current BLS and ACLS certifications (required). Experience Minimum 2 years of nursing experience required. At least 1 year of PACU, ICU, or ED experience strongly preferred. Ambulatory surgery center or interventional pain experience is a plus. Skills & Competencies Strong clinical assessment and post-anesthesia care capabilities. Excellent communication and patient education skills. Proficiency with EMR systems. Commitment to patient-centered care, safety, and confidentiality. Physical Requirements Ability to stand, walk, and assist patients for extended periods. Ability to lift and position patients/equipment as needed. Must be able to respond quickly in emergency situations. Schedule & Benefits Full-time, Monday-Friday (daytime hours) No weekends, holidays, or on-call Enjoy a stable, supportive work environment focused on teamwork and patient care. Powered by JazzHR M6b5SWKNw4
    $52k-72k yearly est. 16d ago
  • Infusion Nurse

    Soleo Health Inc. 3.9company rating

    Utilization review nurse job in Birmingham, AL

    Job DescriptionDescription: Soleo Health is seeking a Full-time Infusion Nurse to support our Infusion patients in the Birmingham, AL and surrounding areas. Join us in Simplifying Complex Care! Soleo Health Perks: Competitive Wages Mileage Reimbursement & Paid Drive Time 401(k) with a Match Referral Bonus Paid Time Off Great Company Culture Annual Merit Based Increases Paid Parental Leave Options Affordable Medical, Dental, & Vision Insurance Plans Company Paid Disability & Basic Life Insurance HSA & FSA (including dependent care) Options Education Assistance Program The Position: The Infusion Nurse provides primary patient care for specifically assigned patients to include assessments, care planning, evaluation and education of patients receiving infusion therapy and/or other nursing services in accordance with the care matrices and best practices in the home or alternate site setting. Responsibilities include: Provide the direct care for all assigned patients including initiation and maintenance of all communications with appropriate care team members including pharmacists, prescribers, dietitians, home patient representatives/care partner and any appropriate community resource staff members. Evaluate and education patient/care partner to safely administer the home infusion therapy and provide additional instruction as indicated. Evaluate the home environment where the care is to be provided and identify interventions that may be required to render the home care environment safe and appropriate for the prescribed care. Develop in conjunction with other team members the plan of care and evaluate response to therapy with each encounter. Develop and maintain caseload scheduling via company approved platform per company policy. Communicate any scheduling changes on an as needed basis to appropriate team members. Coordinate care via approved company platform Takes part in the nurse on-call rotation to ensure continuous nursing support services to our customers. Document all communications at time of service as appropriate per Soleo policy. Strong knowledge of therapies provided by Soleo. Work in conjunction with appropriate departments to ensure all required patient documents are completed and returned to the branch office within acceptable timeframe. Ensures timely submission of plan of treatments as required by states guideline. Schedule: Must be able to work full-time, Monday-Friday 8:30am-5pm, 40 hours per week Must be able to participate in an on-call rotation every 7th weekend Must be knowledgeable of IV access devices to include: IV lines, ports, and administration of infusion medications Must be able to provide infusions to patients in their homes as well as the infusion suite Must be able to drive up to 2 hours as needed to see patients (we offer mileage reimbursement and hourly rate of pay) Requirements: RN Degree, BSN Preferred Advanced certification in specialty areas of practice (e.g., CRNI, ONS, IgRN) preferred but not required. On-Call Requirement: This position requires participation in an on-call rotation, nights and weekends included, providing as-needed support outside of regular business hours to address urgent issues and ensure continuous operations. When on call Administrative Oversight: Responsible for providing administrative oversight, including monitoring of workflows, ensuring compliance with policies, and managing resources efficiently to meet organizational objectives. Emergency Availability: Must be available to respond promptly to emergencies, ensuring rapid and effective resolution of issues to minimize impact on operations. Availability during non-standard hours, including nights, weekends, and holidays, as required by the nature of the emergency. When on call Minimum 3 years nursing experience with background in infusion therapy preferred. Current nursing license for applicable home state Experience in ICU and/or Cardiac Care preferred. Proficient with Microsoft Outlook and Microsoft Office Suite. Valid state issued driver's license with no significant restrictions on that license. About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference! Soleo's Core Values: Improve patients' lives every day Be passionate in everything you do Encourage unlimited ideas and creative thinking Make decisions as if you own the company Do the right thing Have fun! Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture. Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor. Keywords: Nursing, clinic, clinical, IV, patient care, CPR, Acute, outpatient, pharmacy, Emergency room, ICU, home care, internal medicine, GI, neuro, rheumatology, adult, registered nurse, PACU, chronic, home health, Hospice, Acute Care, Critical Care, CRNI, ER, blood products, IVIG, Biologics, TPN, step down, now hiring, hiring now, immediately hiring, hiring immediately, Vascular Access Nurse, Infusion, Specialty Infusion Pharmacy, IV Therapy, IV Infusion, Home Infusion, IV Therapy Administration, Home Infusion Therapy, Specialty Infusion Nursing, Specialty Infusion, RN Clinical Liaison, Infusion Nurse Liaison, CPR+, Alayacare
    $34k-47k yearly est. 26d ago
  • Night Shift Cart Nurse (LPN) - 7p - 7a

    Ball Healthcare 4.3company rating

    Utilization review nurse job in Birmingham, AL

    Job Description Night Shift Cart Nurse - 7p - 7a The Arlington Rehabilitation & HealthCare Center, in Birmingham, AL is currently seeking Licensed Practical Nurses (LPN) to join our team as a Cart Nurse. Minimum Qualifications: Must be a Licensed Practical Nurse (LPN) in good standing and currently licensed by the state of Alabama Must be knowledgeable of nursing and medical practices and procedures and laws, regulations and guidelines Must be able to communicate effectively, both verbally and in writing Must have a comfort and positive attitude in communicating with the elderly who have multiple nursing care needs Job Type: 12-hour shifts, 7p - 7a with Shift Differential Pay! Outstanding Comprehensive Benefits Package! Competitive Pay 401(k) Plan with Matching Funds Medical, Dental, & Vision Coverage Full Suite of Voluntary Coverage Plans Continuing Education Tuition Reimbursement Program Interested in joining our team, email your resume or apply in person at: Arlington Rehabilitation & HealthCare Center 1020 Tuscaloosa Ave. SW Birmingham, AL 35211 - Phone: ************** Arlington Rehabilitation & HealthCare Center is an Equal Opportunity Employer
    $30k-44k yearly est. 9d ago
  • Nurse Navigator FT Day

    Orlando Health 4.8company rating

    Utilization review nurse job in Homewood, AL

    Baptist Health Brookwood Hospital Directly responsible for providing supportive care transition services to patients aligned to the health system's value-based care programs in collaboration with clinical and administrative stakeholders across the organization. Serves as part of a multi-disciplinary team to connect with our managed patient populations and their families, ensuring the necessary resources are in place to timely, safely, and effectively navigate the patient between each site of care until the patient is successfully discharged to home. Responsibilities Essential Functions: • Possesses a strong understanding of medical terminology and understands healthcare operations, patient engagement, physician relations and all other healthcare related issues. • Takes initiative to develop knowledge, skills, and abilities to perform at a high level in the care transition navigation role, including staying abreast of related care transition management news, documentation, and literature. • Ensures compliance with all necessary risk management programs, corporate quality initiatives, and other corporate objectives. • Partners with various healthcare entities and physician practices to foster integrated relationships with patients, families, and caregivers to facilitate streamlined patient transitions across the continuum of care. • Assists patients and caregivers in navigating care services post-hospitalization, including development of patient-tailored post-acute care plans and routine patient monitoring to ensure plan adherence. • Engages with patients using strong communication skills and utilizes patient feedback to identify current service needs and anticipate future service needs using a patient-first philosophy. • Distributes approved educational materials and other care transition resources to patients and caregivers to effectively remove social determinants of health barriers with the goal of preventing readmissions and other avoidable care events. • Advocates for patient needs by proactively identifying barriers to treatment plans and ensuring patients have access to needed prescriptions, durable medical equipment, and other care services, as necessary. • Collaborates with the population health and value-based care departmental nursing team and relevant network aligned physician partners to share, discuss, and modify care transition plans, as needed. • Maintains a high level of proficiency with organizational informational systems, including ELLiE Healthy Planet modules, to ensure care transition support for our covered populations is efficient, timely, and effective. • Performs other duties as assigned to support the health system's overall population health and value-based care team objectives. • Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards. • Maintains compliance with all Orlando Health policies and procedures. Other Related Functions: • Works comfortably in teams as a participant and facilitator, including temporary teams for project-based initiatives. • Possesses the ability to prioritize and work independently in addition to being an integral part of the care team. • Communicates effectively through all forms of media and leverages critical thinking skills to effectively solve problems. • Documents work efforts in an organized and accessible fashion while respecting confidentiality/privacy standards. • Contributes to environment of psychological safety where ideas are welcomed, considered, and appreciated. Qualifications Education/Training: High school diploma or GED required. Licensure/Certification: None. Experience: One (1) year experience as a Medical Assistant, Paramedic, Emergency Medical Technician, Military Allied Health Professional, Nursing Assistant or related health care role in value-based care or physician offices required
    $40k-53k yearly est. Auto-Apply 19d ago

Learn more about utilization review nurse jobs

How much does a utilization review nurse earn in Vestavia Hills, AL?

The average utilization review nurse in Vestavia Hills, AL earns between $42,000 and $72,000 annually. This compares to the national average utilization review nurse range of $47,000 to $89,000.

Average utilization review nurse salary in Vestavia Hills, AL

$55,000
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