, development, implementation, and maintenance of all QRM policies and procedures. Monitors utilization trends concerning inpatient... review or quality issues to Quality and Risk Management. Provides documentation regarding any pertinent patient information...
with providers, claims or service issues. Assists with development of utilization/care management policies and procedures...; or any combination of education and experience, which would provide an equivalent background. Current unrestricted RN license...
in an acute care setting through direct patient care, utilization review, case management or quality review with passing score... in a JA Thomas Clinical Documentation Improvement program. Current RN license in Georgia. Minimum 4 years experience in nursing...
years experience in nursing in an acute care setting through direct patient care, utilization review, case management... of two years experience in a JA Thomas Clinical Documentation Improvement program. Current RN license in Georgia. Minimum 4...
experience in nursing in an acute care setting through direct patient care, utilization review, case management or quality review... years experience in a JA Thomas Clinical Documentation Improvement program. Current RN license in Georgia. Minimum 4 years...
in Georgia. Minimum 4 years experience in nursing in an acute care setting through direct patient care, utilization review, case... in Nursing with a minimum of two years experience in a JA Thomas Clinical Documentation Improvement program. Current RN license...
disorder facility-based and outpatient professional treatment health benefits through telephonic or written review. Primary..., such as RN LCSW LMSW LMHC LPC LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health...
disorder facility-based and outpatient professional treatment health benefits through telephonic or written review. Primary..., such as RN LCSW LMSW LMHC LPC LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health...
of working as a CDI/Coding auditor is preferred Prior experience of working in inpatient case management or utilization review... that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity...
. Assists with development of utilization/care management policies and procedures. Minimum Requirements: Requires BA/BS..., which would provide an equivalent background. Current, unrestricted RN license in applicable state required. Multi-state licensure...
auditor is preferred Preferred and Prior experience of working in inpatient case management or utilization review is preferred... within 180 Days Reg Nurse (Single State)-Preferred or RN - Multi-state Compact-Preferred or Cert Coding Spec-Preferred or Cert...
. In collaboration with Utilization Review, the SW CM will initiate and facilitate discussions with the payors to act as an advocate... manner, coordinating directly with the patient/family as well as the care team. Through continuous assessment and review, the...
. In collaboration with Utilization Review, the SW CM will initiate and facilitate discussions with the payors to act as an advocate... manner, coordinating directly with the patient/family as well as the care team. Through continuous assessment and review, the...
. In collaboration with Utilization Review, the SW CM will initiate and facilitate discussions with the payors to act as an advocate... manner, coordinating directly with the patient/family as well as the care team. Through continuous assessment and review, the...
which reflects favorably upon the organization. In collaboration with Utilization Review, the SW CM will initiate and facilitate... as the care team. Through continuous assessment and review, the SW CM will apply critical thinking to ensure alignment...
. Assists with development of utilization/care management policies and procedures. Minimum Requirements: Requires a BA/BS... an equivalent background. Current, unrestricted RN license from the State of Georgia required. Multistate licensure...
or written review. How you will make an impact: Uses appropriate screening criteria knowledge and clinical judgment to assess... active unrestricted license such as LCSW LMSW LMHC LPC LBA (as allowed by applicable state laws) LMFT RN or Clinical...
are managed, evaluated, and capture accurate resource utilization at all the facilities levels. Partner with the Clinical... and Responsibilities: Develop and implements case management and clinical reimbursement programs. Review weekly/monthly RUG...