each and every day. Job Description: The Utilization Review RN performs activities which support the Utilization Management... optimal management of clinical resources by conducting timely admission and concurrent utilization review for all patients...
each and every day. Job Description: The Utilization Review RN performs activities which support the Utilization Management... optimal management of clinical resources by conducting timely admission and concurrent utilization review for all patients...
in the UM Department. The Utilization Review Coordinator is responsible for executing the UR function, which includes the... review organizations or comparable entities. Licensure: None required unless RN. Additional Requirements: May...
in the UM Department. The Utilization Review Coordinator is responsible for executing the UR function, which includes the... review organizations or comparable entities. Licensure: None required unless RN. Additional Requirements: May...
: Job Description Summary: The RN: Case Manager promotes optimal health care outcomes in accordance with the policies, procedures, applicable... for the appropriate utilization of facilities and services; serves as a resource to physicians, nurses and ancillary staff...
Required: Three years nursing Bachelor Degree Registered Nurse Desired: Three years in utilization review, behavioral...Job Description: Responsibilities The RN Navigator works closely with patients across all aspects of the continuum...
, professional, and appropriate documentation as reflected in the Quality Review Audit process Advocates for patient/family needs... healthcare team in the management of unusual or questions cases. Educates the healthcare team about the role of the RN: Case...
and updating all FMS manuals. Accountable for completion of the Annual Standing Order Review and ICD coding. Checks... as required supporting billing and collection activities. Responsible for efficient utilization of medication, laboratory, inventory...
care management or case management experience and requires a minimum of 2 years clinical, utilization review, or managed... active, valid and unrestricted RN license and/or certification to practice as a health professional within the scope...
utilization of all patient care resources (i.e. durable medical equipment, supplies) and communicates with primary RN, customer...’ needs. Provides additional CNA services to patients as requested by RN. Collaborates with Clinical Manager and/or Clinical...
collections and auditing activities. Manages clinic financials including efficient utilization of supplies or equipment... and regular profits and loss review. Responsible for all required network reporting and on-site state or federal surveys...
of denied reimbursement for hospital services rendered to a patient by providing a comprehensive review of a members’ clinical..., Experience, Licensure and Certification) Education: Licensed/certified healthcare professional, such as LPN, RN, OTR...
of care managers (including system care managers), utilization review nurses (RN, LPN) and insurance verification... representatives. This team will develop processes for prospective, concurrent and retrospective utilization review. They will provide...
, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review... management, utilization review, or discharge planning...
providers, attorneys, advisors/clients, and coworkers A cost containment background, such as utilization review or managed care... and within a team environment EDUCATION & EXPERIENCE: Experience as an RN Medical Case Manager is ideal, or a clinical background...