. Documents all reviews in designated software system. Conducts admission and concurrent medical record review using established.... Job Description: On a concurrent basis the Care Coordinator (CC) utilizes appropriate/standardized criteria to determine the optimal level of care...
Utilization Management functions, which includes: admission, concurrent and retrospective utilization review for medical necessity... experience of 5 or more years in lieu of BSN degree. Requires minimum of five years' clinical experience as staff nurse. Prior...
healthcare services clinical review determinations for Medicare Line of Business. The Manager, Utilization Management Nurse...Your Role The Utilization Management Concurrent Review team ensures accurate and timely authorization of designated...
Nurse Manager. In this role you will be assigned a list of inpatient facilities and then review clinical information... or for a specific line of business such as Medicare and FEP Conducts clinical review of claims for medical necessity, coding accuracy...
standards Conducts concurrent and retrospective chart review for the purpose of identifying opportunities for improvement... Medical Center we support our colleagues in their positions. Join our Team as a(an) Registered Nurse RN Chest Pain Coordinator...
PI database to ensure adequate documentation as required by regulatory agencies. Complete concurrent review of cases...Description Introduction Do you have the career opportunities as a(an) Registered Nurse RN Trauma Coordinator...
, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in health... medical determinations or provide recommendations based on requested services and concurrent review findings Assists...
Job Description: Your Role The Utilization Management Concurrent Review team ensures accurate and timely... authorization of designated healthcare services clinical review determinations for Medicare Line of Business. The Manager...
position to all audiences Performs other duties as assigned Position: UM Outpatient Clinical Review Nurse /Utilization... level of care, using applicable coverage documents and clinical guidelines Collects, documents, and maintains review...
Clinical Review Coordinator is responsible for concurrent review for post-acute levels of care. Review clinical documents... member’s clinical information from providers Perform utilization review of inpatient cases using Interqual Criteria...
Scheduled Bi-Weekly Hours 80 Work Shift Day: 8 hours Job Description The Clinical Utilization Review and Appeals... Coordinator combines clinical, business and regulatory knowledge and skill to reduce financial risk and exposure caused...
Under general supervision of the Director of Case Management, the Utilization Review Nurse provides a clinical review.... Experience: Two years of clinical nursing experience and utilization review experience preferred. Licensure/Certification...
Job Description: Under general supervision of the Director of Case Management, the Utilization Review Nurse provides... a clinical review of cases using medical necessity criteria to determine the medical appropriateness of inpatient and outpatient...
RN- Utilization Review Nurse Inpatient *Full Time - 100% Remote Opportunity* COME WORK FOR THE LEADING, LOCAL... MANAGED CARE COMPANY - VILLAGE CARE! VillageCare is looking for a self-motivated and passionate RN as Utilization Review...
RN- Utilization Review Nurse Inpatient *Full Time - 100% Remote Opportunity* COME WORK FOR THE LEADING, LOCAL... MANAGED CARE COMPANY - VILLAGE CARE! VillageCare is looking for a self-motivated and passionate RN as Utilization Review...
. The Clinical Care Reviewer – Utilization Management will also be counted upon to: Conduct concurrent reviews by assessing.... Discover more about us at www.amerihealthcaritas.com. Responsibilities: Under the direction of a supervisor, the Clinical...
Job Category: Revenue Cycle Job Description: Cottage Health seeks a Utilization Review Manager, Registered Nurse... for their Clinical Denials and Appeals department responsible for the overall management of utilization review processes and clinical...
in discharge. Documents all Avoidable Days in CANOPY system. Performs clinical review on admission and/or continued stay using...UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part...
Utilization Review Nurse – LTSS (Contract-to-Perm) Location: Remote however Candidates must reside in one of the... for professional growth across the country. Position Overview The Utilization Review Nurse (LTSS) supports the Utilization...
Job Description Use established medical policy and guidelines to perform prospective, concurrent, and retrospective... medical necessity review of post-acute care services to ensure medical necessity for appropriate setting, appropriate length...