Utilization Review Nurse (RN) - $42-$65/hr + Sign-On Bonus Job at Lancesoft INC, Las Vegas, NV

  • Lancesoft INC
  • Las Vegas, NV

Job Description

Job Description

Job Description

Utilization Review Nurse
Location: Las Vegas, NV
Job Type: Full-Time
Pay: $42–$65/hr + Sign-On Bonus

Job Summary

Review patient admissions and continued stays to ensure medical necessity, appropriate resource utilization, and compliance with payer and regulatory requirements.

Responsibilities

  • Review admissions and continued stays for medical necessity.
  • Apply InterQual and/or Milliman (MCG) criteria.
  • Collaborate with physicians, case managers, and healthcare teams.
  • Support discharge planning and care coordination.
  • Maintain accurate documentation and regulatory compliance.

Qualifications

  • Graduate of an accredited School of Nursing.
  • Current RN license in the applicable state.
  • 5+ years of acute care nursing experience.
  • 1+ year of Utilization Management, Case Management, or Clinical Documentation Improvement experience.

Preferred Qualifications

  • 3+ years of Utilization Management experience.
  • 3+ years of discharge planning experience in an acute care setting.
  • Recent experience with InterQual and Milliman (MCG) guidelines.
  • Knowledge of Medicare, Medicaid, and commercial payer requirements.

Skills

  • Strong clinical assessment, communication, analytical, and documentation skills.

\nCompany Description

LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.

Company Description

LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.

Job Tags

Full time, Relocation package

Similar Jobs

Prestigetravelpartner

Remote Travel Marketing Coordinator Job at Prestigetravelpartner

 ...Prestigetravelpartner is seeking a Remote Travel Marketing Assistant to support travel planning, digital marketing, and online client engagement. You will assist clients, communicate via digital channels, and help create engaging travel content from home. This role... 

MURDOCK PEDIATRIC SERVICES

Pediatric Nurse Practitioner / Physician Assistant Job at MURDOCK PEDIATRIC SERVICES

 ...Job Description Job Description Pediatric Nurse Practitioner / Physician Assistant Location: Cleveland, Texas (Near Kingwood & The Woodlands) Position Highlights ~ MondayFriday schedule ~ No nights ~ No weekends ~ No hospital rounds ~ No newborn nursery... 

Collectors Holdings, Inc.

Legal Operations Manager Job at Collectors Holdings, Inc.

 ...expectations and answer any questions you have. We are seeking a Legal Operations Specialist to join our in-house Legal team. This role sits at...  ...four days a week. What You'll Do Contract Operations: Manage contract intake, review workflows, renewal tracking, and... 

Spieldenner Group

Field Underwriter (WFH) Job at Spieldenner Group

 ...through mortgage protection coverage. No experience? No problem. We provide training,...  ...Coachable and self-motivated Strong work ethic Growth mindset Comfortable working...  ...Proven systems and lead support Fully remote, flexible work environment Growth-focused... 

Consolidated Precision Products

Ceramics Shell Process Engineer Job at Consolidated Precision Products

 ...Ceramics Shell Process Engineer If you would love to be part of a company that is poised for substantial growth with opportunities for career advancement, then working for CPP may be the right fit for you! Join a results-oriented workplace that strives for success...