- Centene Corporation (New York, NY)
- …license.** **Inpatient Utilization Management** **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical ... between utilization management team, members, and providers + Monitors prior authorization, concurrent review , and/or retrospective clinical review nurses… more
- Mount Sinai Health System (New York, NY)
- …clinical information requested by the managed care companies as part of the concurrent review in a timely fashion. 13. Provides clinical information requested ... preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a… more
- AdventHealth (Orlando, FL)
- …stewardship in the management of resources entrusted to them. Reviews concurrent medical record for compliance including completeness and accuracy for severity ... risk of mortality (ROM) and quality. Completes accurate and timely record review to ensure the integrity of documentation compliance. Completes accurate and concise… more
- Northwell Health (Forest Hills, NY)
- …Masters Degree, preferred.Current license to practice as a Registered Professional Nurse in New York State.Patient Review Instruments (PRI) Certification, ... etc 2. are appropriately arranged for and financially approved.Performs concurrent utilization management.Reviews appropriateness of patient's admission, need for… more
- AdventHealth (Orlando, FL)
- …role you'll contribute:** The Clinical Documentation Integrity Manager is a Registered Nurse and/or a Registered Health Information Administrator with a high level ... of registered nurses and clinical documentation specialists. This role will oversee the review processes of complex patients that vary in age and have different… more
- ChenMed (Newport News, VA)
- …+ Participates in surveys, studies and special projects as assigned. + Conducts concurrent medical record review using specific indicators and criteria as ... we need great people to join our team. The Nurse Case Manager 1 (RN) is responsible for achieving...with patient and family. + Facilitates patient/family conferences to review treatment goals and optimize resource utilization; provides family… more
- University of Michigan (Ann Arbor, MI)
- …and care of their children. The Pediatric Cardiothoracic Intensive Care Unit nurse cares for patients in a technology-intensive environment, including ECMO, CRRT, ... in Nursing staff development programs and workshops. + Participate in a concurrent and retrospective evaluation of patient care consistent with the hospital quality… more
- Penn State Health (Camp Hill, PA)
- … and approve patients for inclusion in stroke database. + Facilitate chart review , both concurrent and retrospective. + Collaborate on preparation and ... serve as a performance improvement resource for the bedside nurse caring for stroke patients. + Attend Unit Accountable...Care Team and PCNC meetings on nursing units. + Review performance measure compliance, log noncompliance, and follow up… more
- Intermountain Health (Grand Junction, CO)
- …**ccasional weekend or holiday work may surface.** **Essential Functions** + Provides concurrent review of medical record to ensure documentation meets quality ... information. + Facilitates modifications to clinical documentation through extensive concurrent interactions with physicians, therapists, nursing staff, coding and… more
- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient ... charts and records to evaluate care concurrent with patients' treatment. Reviews treatment plans and status...insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use… more