- Children's Mercy Kansas City (Kansas City, MO)
- …of children beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise, evidence-based guidelines, insurance ... authorization per contracts for medically appropriate level of care. Manages concurrent clinical denials through completion of verbal reconsideration process. Works… more
- Children's Mercy Kansas City (Kansas City, MO)
- …issues. The High-Risk Nurse Lead is an expert at the roles of Clinical Review Nurse Care Manager and Care Coordination Case Manager and provides support to ... lives of children beyond the walls of our hospital. Overview The High-Risk Nurse Lead manages high risk administrative processes and data related to medical… more
- Centene Corporation (Jefferson City, MO)
- …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... including a fresh perspective on workplace flexibility. POSITION IS REMOTE BUT CANDIDATE MUST RESIDE IN STATE OF MISSOURI...WITH FOSTER CARE POPULATION **Position Purpose:** Performs a clinical review and assesses care related to mental health and… more
- SSM Health (MO)
- **It's more than a career, it's a calling** MO- REMOTE **Worker Type:** Regular **Job Highlights:** Additional Job Description Must have prior experience as a ... (patient safety indicator) or experience with Vizient specialized mortality reviews. **Eligible Remote States:** Candidates are required to reside on one of SSM's… more
- SSM Health (MO)
- …and provides feedback to clinical staff regarding these requirements during the concurrent record review process. + Maintains knowledge of mortality models, ... **It's more than a career, it's a calling.** MO- REMOTE **Worker Type:** Regular **Job Summary:** Performs as...rate/expected rate (O/E ratios), industry trends, variable and diagnosis review group (DRG) frequency. + Serves as a liaison… more