- 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
- BrightSpring Health Services (Gainesville, FL)
- …of Nursing is unavailable + Participates on the safety, infection control, incident review and human rights committees + Facilitates communication and serves as a ... education coursework to facilitate licensure as a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN)...governing sources + Excellent communication with ability to handle concurrent tasks and responsibilities + Ability to work as… more
- Providence (Beaverton, 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
- AdventHealth (Daytona Beach, FL)
- …Ancillary Departments to develop and implement improvement initiatives. Actively participates in concurrent case review to assure that evidence based best ... the assessment, planning, implementation and evaluation of the multi-disciplinary Physician Peer Review Program for FHMMC. **The value you'll bring to the team:** +… more
- Stanford Health Care (Palo Alto, CA)
- …include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness ... ensuring optimum use of resources, service delivery, and compliance with external review agencies' requirements. Case Managers act as consultants to the clinical… more
- Missouri State University (Springfield, MO)
- …to patients. 5. Develops and implements processes for retrospective patient care review , concurrent assessment of clinical practice, credential and privileges ... first date of consideration is November 18, 2025, and review of applications will continue until the position is...availability and role requirements. Option 1 + One full-time Nurse Practitioner (NP) or Physician Assistant (PA), and +… more
- CareFirst (Baltimore, MD)
- …**PURPOSE:** Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent and retrospective ... Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist, will analyze clinical information, contracts, mandates, medical… more
- HCA Healthcare (Corpus Christi, TX)
- …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...within 30 days of employment start date + Emergency Nurse Pediatric Cour must be obtained within 30 days… more
- CareFirst (Baltimore, MD)
- …The Onsite Clinical Navigator (RN) embedded at a partnering hospital will conduct concurrent review of inpatient level of care, managing the timely and ... level of care. Applies sound clinical knowledge and judgment throughout the review process. Follows member benefit contracts to assist with benefit determination. +… more
- Presbyterian Homes and Services (Roseville, MN)
- …end splits, review all expedited appeals and ALJ level appeals. Perform concurrent MDS review to assure appropriate RUGs category is achieved through the ... capture of appropriate clinical information. + Perform monthly QI/QM review for assigned region and provide recommendations to IDT and MDS Nurses. + Complete triple… more