- 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 ... accredited school of nursing and a current state Registered Nurse license. + Grandfathered prior to April 1, 2015....of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. +… more
- Elevance Health (Tampa, FL)
- …+ Requires HS diploma or equivalent and a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid and ... ensuring appropriate, consistent administration of plan benefits by reviewing clinical information and assessing medical necessity under relevant guidelines and/or… more
- Northwell Health (Lake Success, NY)
- … clinical documentation in the patient's medical record through a concurrent review process throughout the patient's inpatient stay. 4.Requests clarification ... of clinical documentation from the physician(s) on a ...date. *Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications… more
- Geisinger (Lewistown, PA)
- …National Healthcare Safety Network (NHSN) reporting criteria and requirements. + Performs concurrent and retrospective medical record review including review ... Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review , we're working to create a national model for...and DOH surveys. At least 2 years of Registered Nurse work experience in a hospital setting is required.… more
- Mayo Clinic (Rochester, MN)
- … Review , including concurrent admission status and continued stay clinical review ; communication with clinical providers to identify quality ... staff regarding quality metrics, and continued admission status review to ensure accurate clinical documentation to...continued admission status review to ensure accurate clinical documentation to support the care provided. This position… more
- Northwell Health (Staten Island, NY)
- **Req Number** 167724 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality patient ... Responsibilities: + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria… more
- Omaha Children's Hospital (Omaha, NE)
- …of service for the severity of illness. UM includes retrospective and concurrent clinical reviews with third-party payors and actively collaborates with ... Guides admitting physician in protocols for conducting physician to physician review with third-party payers. * Appropriately documents all relevant communications… more
- Northwell Health (Mount Kisco, NY)
- …+ Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. ... collaboration with the health care team. + Conducts chart review for appropriateness of admission and continued length of...and continued length of stay; Facilitates throughput. + Conducts clinical reviews and interacts with third party payers to… more
- BrightSpring Health Services (Mount Laurel, NJ)
- …Registered Professional Nurse + Excellent communicator with ability to handle concurrent tasks and responsibilities + Ability to travel within assigned area + ... monitoring both skilled and non-skilled healthcare services + Directly supervises clinical personnel + Providing clinical teaching and conducting performance… more
- Geisinger (Scranton, PA)
- …As one of the Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review , we're working to create a national model for improving health. Today, we're ... reporting potential risk and quality management issues identified from medical record review to appropriate departments through defined processes, and enters data as… more