Interim Utilization Review Nurse (RN) Leader | Hospital System | Southeastern US

Highly Competitive Pay | Lodging Provided | Rental Car Or Mileage | Paid Flights Home | World-Class Support

Location, location, location. The area has a delightful climate year-round, boasting vibrant autumns, rejuvenating springs, inviting summers, and mild winters. Its proximity to beachfront and mountainous landscapes offers visitors unparalleled opportunities for outdoor recreation and adventures. Snow and ice are a rarity, and even in the coldest months, the average low temperatures remain comfortably above freezing, ensuring year-round enjoyment of the great outdoors.

Southeastern, US

• Lead and manage a team of Utilization Review and Appeal Management Specialists
• Oversee daily operations related to utilization review and appeals management across assigned facilities
• Ensure compliance with established policies and procedures, optimize the use of healthcare resources and improve patient care outcomes
• Develop, implement, and continuously improve policies and operational procedures to streamline utilization review and appeal management processes
• Provide guidance, training, and support to staff, ensuring high standards of performance and adherence to protocols
• Work closely with physicians, nursing staff, and other healthcare professionals to coordinate patient care, ensuring efficient use of resources while maintaining quality care standards
• Facilitate efficient utilization of hospital resources to optimize both clinical and financial outcomes
• Implement strategies to reduce unnecessary costs while ensuring high-quality patient care
• Identify areas for improvement within the utilization review process and develop initiatives to enhance patient care delivery, staff efficiency, and compliance with healthcare regulations

• Bachelor’s Degree preferred; Master’s degree a plus
• Active RN License required
• Change Healthcare InterQual Certified Expert Resource Certification required
• Certified Case Manager (CCM) certification desired
• Minimum of 5 years of hospital-based experience in concurrent utilization review and appeals management
• Experience with third-party payor requirements
• In-depth knowledge of Joint Commission and CMS Conditions of Participation
• Ability to establish and maintain effective working relationships with all levels of hospital staff
• Available to travel to the client site and work a full-time schedule, M - F, or as needed

Galileo Staffing Services, a division of Galileo Search, LLC., is a premier provider of interim healthcare specialists, professionals, and executives to nationwide acutecare hospitals. To learn more about Galileo Staffing Services, visit our website at www.galileosearch.com.

How will YOU benefit when working with Galileo?

• Highly competitive pay rates that are best in the industry with weekly direct deposit
• Per diem for the housing of your choice if not provided by the client and for incidental expenses
• Weekly travel expense reimbursement (flights, rental car, or mileage)
• Medical, dental, vision, life insurance, and 401k available
• State License expense reimbursement for endorsement
• Comprehensive professional liability insurance coverage
• Short or long-term assignments
• Local, regional, or national assignments based on availability
• World-class support before, during, and after each assignment

Forward your resume for confidential review or call to discuss this or other available career opportunities. Submit your resume via email for immediate consideration or use our convenient online Galileo Candidate Registry.

Galileo Search, LLC - People and Careers Perfectly Aligned.

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