Medical Review RN / Nurse Specialist II Work from Home within the Continental United States @Orchard LLC..., utilization review, managed care organization quality review, and quality assurance for programs serving individuals...
, teach and collaborate with others. Excellent critical thinking skills related to nursing utilization review Knowledge... but saving them. Together. The Inpatient Review Nurse assists patients through the continuum of care in collaboration with the...
Overview: Medicare Medical Review RN (Medical Reviewer III) - REMOTE The Medicare Medical Review RN (Medical... of medical terminology and experience in the analysis and processing of Medicare claims, utilization review/ quality assurance...
role The Pre-Certification Review Nurse - Pharmacy is responsible for reviewing and processing coverage determinations... and utilization management reviews for specialty medications, to include site of care assessments, for enrollees of Quantum Health...
Medical Review RN / Nurse Specialist II Work from Home within the Continental United States @Orchard LLC..., utilization review, managed care organization quality review, and quality assurance for programs serving individuals...
Medical Review RN / Nurse Specialist II Work from Home within the Continental United States @Orchard LLC..., utilization review, managed care organization quality review, and quality assurance for programs serving individuals...
Purpose: The Registered Nurse Utilization Review (UR), Clinical Care Manger (CCM) actively manages the utilization review... and support team (RN, Physician/Clinical Affiliate, DPA, MSW, CDI, Rehab Services, etc.) to progress each patient's care...
Purpose: The Registered Nurse Utilization Review (UR), Clinical Care Manger (CCM) actively manages the utilization review... and support team (RN, Physician/Clinical Affiliate, DPA, MSW, CDI, Rehab Services, etc.) to progress each patient's care...
is designed to address the growing need for high-quality behavioral health services in the region. The Utilization Specialist... proactively monitors utilization of services for patients to optimize reimbursement for the facility. Responsibilities...
coordination. Oversee the utilization review process, ensuring appropriate utilization of services and adherence to best practices... to utilization management and patient care quality. Qualifications: Education: RN BSN, with a valid multistate license. Master...
of Science degree in Nursing. Experience/Skills: Required: 1. Two year’s experience in utilization review, case management..., or relevant clinical experience. 2. Knowledge of utilization review practices and principles. 3. Ability to form positive...
Overview: Mirror Lake is hiring for a Utilization Specialist! Proactively monitor utilization of services... statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal...
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize reimbursement for the.... Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified...
RN license in AL A minimum of 3 years’ experience in an acute care setting and 2 years’ experience in utilization review... for Utilization Management Registered Nurse: Develop, implement, and administer the quality assurance and utilization review...
and operational leadership to the day to day function of the Utilization Management Team. The UM Nurse Manager will ensure that the... team complies with timeliness, documentation, notification and review quality standards based on the Federal, State, Health...
, utilization management, disease management, auditing or retrospective review experience Equivalent combination of education...Utilization and Care Management Nurse Work from home within Oregon, Washington, Idaho or Utah Build a career...
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...
Behavioral Health is currently seeking a Utilization Review Specialist - PRN to assist the Utilization Department staff..., and Alameda County. PURPOSE STATEMENT: The Utilization Review Specialist coordinates and assesses the inpatient census...
RN license in AL A minimum of 3 years’ experience in an acute care setting and 2 years’ experience in utilization review... for Utilization Management Registered Nurse: Develop, implement, and administer the quality assurance and utilization review...
Job Category: Healthcare Services and Operations Job Description: Your Role The Behavioral Health Utilization... Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC...