- Actalent (Austin, TX)
- Clinical Review Nurse - Concurrent Review Location: Remote - Compact Nursing License required; must be able to work CST hours Schedule: ... Unit: Medicaid About the Role We are seeking a Clinical Review Nurse to perform concurrent reviews for Medicaid members, ensuring appropriate care,… more
- Actalent (Orlando, FL)
- Clinical Review Nurse - Concurrent Review Location: Remote - Candidates can be live anywhere in the US but must be able to work CST hours Schedules ... - 6:30 PM CST Position Overview We are seeking Clinical Review Nurses to join our remote...our remote team. In this role, you will perform concurrent reviews to evaluate medical necessity, determine appropriate levels… more
- Centene Corporation (Columbus, OH)
- …, InterQual knowledge, and discharge planning.** **Additional Details:** Department: Concurrent Review MCD** Business Unit: Corporate** Schedule: Monday-Friday ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a CDI Concurrent Review and Query Specialist? At HCA Healthcare, you come first. HCA Healthcare ... a difference. We are looking for a dedicated CDI Concurrent Review and Query Specialist like you...to physicians for conflicting, imprecise, incomplete, illegible, or inconsistent clinical documentation. This individual need to function in a… more
- Centene Corporation (Jefferson City, MO)
- …administered with quality, cost efficiency, and are within compliance. + Performs a clinical review and assessment of relevant complex post-care services by ... providers, as appropriate, for any discrepancies between prior authorization and concurrent review processes to ensure clinically appropriate determinations +… more
- Centene Corporation (Jefferson City, MO)
- …administered with quality, cost efficiency, and are within compliance. + Performs a clinical review of post-care services by reviewing medical records against ... providers, as appropriate, for any discrepancies between prior authorization and concurrent review processes to ensure clinically appropriate determinations +… more
- Vitalief (Philadelphia, PA)
- …role will support the planning, implementation, and execution of multiple concurrent clinical research studies, including NIH-sponsored, industry-sponsored, and ... operate more efficiently and grow sustainably. The Role We are seeking an experienced Clinical Research Nurse to join our exceptional team as a full-time… more
- Geisinger (Danville, PA)
- …provided. The core of the program uses highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to be coded ... work on site position located in Danville, Pennsylvania. The Clinical Documentation Improvement Program (CDI) is designed to improve...mortality, severity of illness; and initiate documentation of the review . + Pursues a subsequent review of… more
- Geisinger (Danville, PA)
- …provided. The core of the program uses highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to be coded ... Job Summary The Clinical Documentation Improvement Program (CDI) is designed to...Dayshift; Monday through Friday. Candidates must hold a Registered Nurse license in Pennsylvania or a Multistate License. A… more
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- …in patient care through systematic evaluation and analytical review of clinical information. Responsibilities Responsibilities of the RUR nurse include, but ... on Service Connection (SC), non-SC, Special Authority (SA), precertification, prospective review , concurrent review , denial management, retrospective … more