- HCA Healthcare (Anchorage, AK)
- …database to ensure adequate documentation as required by regulatory agencies. + Complete concurrent review of cases to identify quality, timelines and systems of ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...and Patient Safety (PIPS) Program. The PI Coordinator will review the continuum of care to determine compliance with… more
- Commonwealth Care Alliance (Boston, MA)
- …for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized clinical ... reviews). * Hire, train and mentor UM staff, including nurse reviewers and support personnel. * Act as liaison...& Abilities (must have): * Expertise in managing utilization review processes including prior authorization, concurrent and… more
- Sharp HealthCare (San Diego, CA)
- …**Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree in Nursing; ... requires the ability to combine clinical/quality considerations with regulatory/financial/utilization review demands to assure patients are receiving care in the… more
- Sharp HealthCare (La Mesa, CA)
- …Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing **Hours** **:** **Shift Start ... requires the ability to combine clinical/quality considerations with regulatory/financial/utilization review demands to assure patients are receiving care in the… more
- Providence (OR)
- …Planning, Coordination of Outpatient Care) + Utilization Management Experience (EX. Concurrent Review , Prior Authorization, Medical Audits, Appeals or ... are terminal and nearing end of life + Care management services include: nurse education, care coordination and general assistance with managing day to day… more
- Sharp HealthCare (La Mesa, CA)
- …real and potential quality issues through measurement and analysis along with concurrent and retrospective review of performance information. Assists with ... Healthcare Quality (CPHQ) - National Association for Healthcare Quality; California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Professional in… more
- HCA Healthcare (Kissimmee, FL)
- …database to ensure adequate documentation as required by regulatory agencies. + Complete concurrent review of cases to identify quality, timelines and systems of ... and Patient Safety (PIPS) Program. The PI Coordinator will review the continuum of care to determine compliance with...6 months of employment start date + (RN) Registered Nurse + Associate Degree, or Registered Nurse … more
- CareFirst (Baltimore, MD)
- …The On-Site Clinical Navigator (RN) embedded at a partnering hospital will conduct concurrent review of inpatient level of care, managing the timely and ... and hospital staff, participates in clinical knowledge and judgement throughout the review process. Applies sound clinical knowledge and judgment throughout the … more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ... healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital utilization review plans… more
- PeaceHealth (Vancouver, WA)
- …status, documentation for medical necessity of admission and continued hospitalization and concurrent review . Educates patients and families about their hospital ... compensation for BSN, MSN, DPN and specialty nursing certification + Professional Nurse Advancement Program with additional pay incentives + A mission driven… more