- Prime Healthcare (Inglewood, CA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... illness. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A current California State Registered Nurse (RN) license is required. 2. Five years acute care nursing… more
- Henry Ford Health System (Warren, MI)
- …criteria and critical thinking to maximize reimbursement. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse required. + Minimum 3-5 years of clinical experience ... of hospital resources and the quality of patient care rendered. Combines clinical , business, regulatory knowledge, and skill to reduce significant financial risk and… more
- Trinity Health (Dubuque, IA)
- …program + Develops a quality improvement plan utilizing the trauma registry and concurrent patient review + Addresses quality issues with nurses, physicians and ... other departments as needed (eg, Shared Services for contract review ) + Works with Stroke Coordinator to improve pre-hospital...Center + Liaises with NICC and promotes a positive clinical experience for EMT students at Mercy One +… more
- Prime Healthcare (Riverdale, GA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/230280/case-manager-registered- nurse /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySouthern Regional… more
- Prime Healthcare (East Liverpool, OH)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/230113/registered- nurse -case-manager/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityEast Liverpool… more
- Prime Healthcare (East Liverpool, OH)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/228334/registered- nurse -case-manager/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityEast Liverpool… more
- LA Care Health Plan (Los Angeles, CA)
- …prospective, concurrent , post-service, and retrospective claim medical review processes. Utilizes clinical judgement, independent analysis, critical-thinking ... and processes. Actively participates in the discharge planning process, including providing clinical review and authorization for alternate levels of care, home… more
- University of Southern California (Alhambra, CA)
- …8. Perform telephonic, and if appropriate, on-site initial/ concurrent review on identified in-patient members. Direct pertinent clinical ... quality patient care. The Case Manager will leverage their clinical and social work experience to ring an understanding...of the Case Manager overlap into inpatient duties including: Concurrent review of all patients to validate… more
- Nuvance Health (Danbury, CT)
- …care. Develop clinical criteria and guidelines for efficient UR processes. * * Concurrent Review :* Oversee the concurrent review process, monitoring ... leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non- clinical ...nurse (RN) * Minimum of 5 years of clinical experience in an acute care setting * Minimum… more
- Trinity Health (Syracuse, NY)
- …administrative requirements for Utilization Management and works collaboratively with Utilization Management/ Concurrent Review Nurse , physicians, staff and ... possible concurrent denials, forwards information to the appropriate Utilization Management/ Concurrent Review Nurse within identified process standards *… more