Remote Nursing Jobs · Utilization Review

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  • Conducts medical necessity reviews to determine appropriate patient class designation.
  • Performs timely reviews using InterQual Criteria and clinical nursing judgement.
  • Communicates with the provider team regarding patient class designation and medical necessity.

Emory Healthcare fuels professional journeys with benefits, resources, mentorship, and leadership programs. They offer a supportive environment for career growth.

  • Assess, plan, coordinate, and monitor patient care.
  • Develop, implement, and monitor individualized care plans.
  • Coordinate care across providers, facilities, and community resources.

Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for dynamic and growing healthcare facilities. They connect clients with highly qualified professionals, offering tailored services to meet unique business needs, leveraging an extensive global network.

  • Contact patient and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs.
  • Develop treatment plan for standard and catastrophic cases in collaboration with the patient, caregivers or family, community resources and multi-disciplinary healthcare providers that include obtainable short- and long-term goals.
  • Advocate for the patient by facilitating the delivery of quality patient care, and by assisting in reducing overall costs; provide patient/family with emotional support and guidance.

Personify Health created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. They serve employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes and have a mission to empower people to lead healthier lives.