- Centene Corporation (Tallahassee, FL)
- …flexibility. **Must Reside in Florida!** **Centene is Hiring!** **We're looking for a Remote Concurrent Review Nurse to support our Medicaid team.** **Ideal ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… 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
- 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...care facility required Licenses, Certifications, & Training: + Registered Nurse - Currently licensed as a Registered Professional … more
- Houston Methodist (Houston, TX)
- … functions through point of entry, observation progression of care management, concurrent review and denials reviews. Additionally, the URSN will prospectively ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is... (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity… more
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- …on Service Connection (SC), non-SC, Special Authority (SA), precertification, prospective review , concurrent review , denial management, retrospective ... Summary The Revenue Utilization Review (RUR) nurse is under the supervision of the Nurse Manager and ANM. The RUR nurse is an active member of the… more
- George C. Grape Community Hospital (Hamburg, IA)
- Quality/Utilization Review Nurse Position Summary: The Quality/Utilization Review Nurse is responsible for evaluating the medical necessity, ... infection prevention protocols and regulatory compliance. Key Responsibilities: * Utilization Review : o Conduct concurrent and retrospective reviews of patient… more
- CDPHP (Latham, NY)
- …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care reviews, post-acute care… more
- UNC Health Care (Kinston, NC)
- …the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying established criteria ... of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service,...3-5 years of applied clinical experience as a Registered Nurse required. + 2 years utilization review ,… more
- YesCare Corp (Brentwood, TN)
- …+ Assist in the control of utilization of resources, pre-occurrence monitoring, concurrent monitoring, intervention and retrospective review . + Track, trend and ... that is transforming lives through care and expertise. **Key Responsibilities:** + The nurse will focus on what's best for the patients within assigned contracts and… more
- Dignity Health (Chandler, AZ)
- …the general direction of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the ... Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on… more