- HCA Healthcare (Aventura, FL)
- …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...multidisciplinary monthly Trauma Systems & Operations Committee and Peer Review meetings. **What qualifications you will need:** + Minimum… more
- Kaleida Health (Buffalo, NY)
- …team, Nursing, Patient Management, Quality Department and ancillary staff to perform concurrent analytical review of clinical documentation and coding data. ... and other members of the health care team. Also responsible for audit review to identify potential documentation deficiencies in specific records and to identify… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …monitoring, oversees all Clinical Services (CS) functions (prior authorization, concurrent review , appeals, case management, disease management, population ... monitoring, oversees all Workers' Compensation (WC) Case Management and Utilization Review (UR) Programs. + Collaborates with the Chief Medical Officer on… more
- Carle Health (Champaign, IL)
- …Field, Work Experience: Clinical bedside; CDI Responsibilities Conducts the initial concurrent review process for all selected admissions. Clarifies ... Overview Performs inpatient chart review to determine appropriate DRG assignment and assures appropriate documentation in the chart to support clinical care… more
- Trinity Health (Livonia, MI)
- …services. Responsible for charge capture in Revenue Integrity assigned areas. Review 's chart, including nursing notes, physician orders, progress notes, and surgical ... correct encounter, correct date of service, with any required modifiers. Review 's documentation, abstracts data and ensure charges/coding are in alignment within… more
- HCA Healthcare (Manchester, NH)
- …at the community and state levels. Participates in State Trauma committees. Conducts concurrent monitoring and evaluation of trauma system plan by ongoing review ... the trauma committee, prepares agendas and selects cases for review according to the operational guidelines of the trauma...registration in the State of NH as a Registered Nurse + Current BLS, ACLS, PALS, TNCC required. CEN… more
- MVP Health Care (Rochester, NY)
- …the Medical Director to ensure appropriate outcomes. + Service Authorization & Review : Conduct prospective, concurrent , and retrospective reviews to determine ... + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management required within...with an established interdisciplinary team. + The role requires review of a comprehensive assessment and development of a… more
- Molina Healthcare (Fort Worth, TX)
- …requests in timely support of nurse reviewers, reviews cases requiring concurrent review and manages the denial process. * Monitors appropriate care ... for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. * Provides leadership and consultation… more
- Northwell Health (Staten Island, NY)
- …to another level of care according to regulatory standards. * * Performs concurrent utilization management using Interqual criteria. * Conducts chart review for ... Sheet and the Patient Transfer Sheet. * Ensures Patient Review Instrument (PRI) is completed and reflects clinical profile...* Current license to practice as a Registered Professional Nurse in New York State. * Case Management Certification,… more
- HCA Healthcare (Miami, FL)
- …Summary and Qualifications** The QualityCoordinatoris responsible for performing concurrent and retrospective quality management / practice improvementreviewsas ... by the individual departments / divisions includingcomplication & mortality review ,nationalquality indicatorreview,TJC indicator/standards reviewand other specified indicator monitoring, data… more