- Children's Mercy Kansas City (Kansas City, MO)
- …can improve the lives of children beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise, ... from admission through hospital stay to discharge. Adeptly uses evidence based clinical practice guidelines to determine the appropriate level of care and the… more
- Centene Corporation (New York, NY)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... and cost effectiveness of medical care. + Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in… more
- Centene Corporation (Phoenix, AZ)
- …senior management to identify and implement opportunities for improvement. + Performs clinical review of outcomes including creating and editing denial letters ... and maintenance with the correspondence team + Investigates denials through comprehensive review of clinical documentation, clinical criteria/guidelines, and… more
- Centene Corporation (Phoenix, AZ)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… more
- Centene Corporation (Sacramento, CA)
- …administered with quality, cost efficiency, and are within compliance. + Performs a clinical review of post-care services by reviewing medical records against ... Remote Role, California RN Licensing Highly Preferred **Position Purpose:** Performs a clinical retrospective review of services previously provided to determine… more
- R1 RCM (Salt Lake City, UT)
- …AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you will help review and interpret medical records to ... production-drive position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical records to appeal… more
- UCLA Health (Los Angeles, CA)
- Description The Quality Management Nurse is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with healthcare standards and ... regulations. This role involves evaluation clinical practices, identifying areas for improvement, and implementing quality improvement initiatives to enhance patient… more
- Henry Ford Health System (Wyandotte, MI)
- …in collaboration with the Medical Staff Leadership Team, the Clinical Peer Review Coordinator is a registered nurse who performs project work of a ... and implementation of medical staff quality and safety projects. The Clinical Peer Review Coordinator is responsible for the collection and analysis of Quality… more
- HCA Healthcare (Austin, TX)
- …step in your career path, we encourage you to apply for our Float Pool Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Description** **Introduction** Do you have the career opportunities as a(an) Float Pool Clinical Nurse Coordinator you want in your current role? We invest in… more
- HCA Healthcare (Myrtle Beach, SC)
- …step in your career path, we encourage you to apply for our RN Medsurg Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... up to 15k!** Do you have the career opportunities as a **RN Medsurg Clinical Nurse Coordinator** you want in your current role? We invest in what matters most… more