- Centene Corporation (San Diego, CA)
- …8 pm (CST)** **Remote - CA or Remote - TX** **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse. ... in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient...Management related to Behavioral Health case is preferred + Clinical knowledge and ability to review and/or… more
- AdventHealth (Orlando, FL)
- …inpatients, sending/presenting opportunities for improved documentation compliance to physicians, nurse practitioners and other clinical team members. ... Virtual **The role you'll contribute:** Under general supervision of the Director of Clinical Documentation Integrity and in some situations the supervision of the … more
- Sharp HealthCare (San Diego, CA)
- …position, and employer business practices. **What You Will Do** Perform admission and concurrent review of patients, based upon needs regardless of payor ... patients.Interfaces with Business Office regarding ongoing certification of stay.Provides concurrent and retro UR reviews to Review Organizations.Identifies… more
- SSM Health (MO)
- …provides feedback to clinical staff regarding these requirements during the concurrent record review process. + Maintains knowledge of mortality models, ... an auditor, and an educator ensuring medical records are complete and clinical documentation comprehensively represents the current health status of network patients… more
- AdventHealth (Orlando, FL)
- …Full Time **Shift** : Days **Location: Remote** **The role you'll contribute:** The Clinical Documentation Integrity Manager is a Registered Nurse and/or a ... nurses and clinical documentation specialists. This role will oversee the review processes of complex patients that vary in age and have different developments… more
- Community Health Systems (Naples, FL)
- …and accurate clinical documentation. Under the direction of the Utilization Review leadership, this role supports concurrent review processes, ... match & more available for Full and Part-Time roles **Job Summary** The Utilization Review Nurse - RN reviews hospital admissions, extended stays, and supporting… more
- UPMC (Pittsburgh, PA)
- UPMC Mercy is hiring a Full Time Trauma Nurse Coordinator to support Trauma Services! This position will work 40 hours per week, primarily during daylight hours. ... candidates will have previous trauma /ER /ICU nursing experience. Purpose: Professional Nurse possessing a high degree of competence and expertise in trauma nursing… more
- McLaren Health Care (Port Huron, MI)
- …peer to peer reviews with payer/providers. 7. Actively participates in clinical case review /rounds with the interdisciplinary team regarding continued ... **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm **Hours Per Pay...to support the level of care being billed. Conducts concurrent reviews to ensure criteria for patient status and… more
- BayCare Health System (Tampa, FL)
- …other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient ... built on a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities… more
- HCA Healthcare (Nashville, TN)
- …charitable organizations. Apply today! **Job Summary and Qualifications** The Quality Nurse Coordinator coordinates and facilitates Quality/Peer Review Committee ... role:** + Perform timely and accurate data collection via concurrent and retrospective clinical medical record reviews....growth, we encourage you to apply for our Quality Nurse Coordinator opening. We promptly review all… more