- Elevance Health (Miami, FL)
- …standard procedures that do not require the training or skill of a registered nurse . **How You Will Make an Impact** Primary duties may include, but are not ... plans and/or contracts. + Conducts and may approve precertification, concurrent , retrospective, out-of-network, and/or appropriateness of treatment setting reviews… more
- Montrose Memorial Hospital (Montrose, CO)
- …and is responsible for completing, tracking, and reporting clinical denial review determinations. This individual will combine clinical, business, and regulatory ... skill to reduce financial risk and exposure caused by concurrent and retrospective denials. The Clinical Denial Analyst is...+ Must at least be Licensed as a Registered Nurse in the State of Colorado or possess a… more
- UCHealth (Aurora, CO)
- …/ hour. Pay is dependent on applicant's relevant experience Summary: Performs concurrent review of clinical documentation in written and electronic medical ... nursing approved Registered/Professional Nursing program. + State licensure as a Registered Nurse (RN). 5 years of recent clinical experience in an acute inpatient… more
- HCA Healthcare (Salem, VA)
- …protocol, corporate standards and other applicable documentation. Provides charge review results and develops and coordinates educational in-services for facility ... to the mapping between Facility chargemaster and Meditech Expanse, performance of concurrent charge reviews to support the application of charges in Patient… more
- Cambridge Health Alliance (Somerville, MA)
- …**Work Days:** Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category:** Registered Nurse **Department:** Inpatient Case Management SH **Job Type:** Full time ... MNA Somerville **This position in onsite in Somerville** Department Description: Utilization review (UR) in behavioral health that evaluates the medical necessity of… more
- Genesis Healthcare (Charles Town, WV)
- …of the MDS assessments including case-mix, OBRA and OSRA required assessments. *Perform concurrent MDS review to insure appropriate RUGs category is achieved ... making a meaningful impact in the communities we serve. Responsibilities The MDS Nurse -- RN manages the overall process and tracking of all Medicare/Medicaid… more
- Elevance Health (Cincinnati, OH)
- …standard procedures that do not require the training or skill of a registered nurse . **How you will make an impact:** + Confirms medical services are appropriate ... plans and/or contracts. + Conducts and may approve precertification, concurrent , retrospective, out-of-network, and/or appropriateness of treatment setting reviews… more
- Queen's Health System (Honolulu, HI)
- …responsible for competency in coordinating and performing day-to-day operations, providing concurrent and/or retrospective review , and improving documentation of ... A. EDUCATION/CERTIFICATION AND LICENSURE: * Current Hawaii State license as a Registered Nurse . * Associate degree in nursing or higher. * Valid US driver's license,… more
- Prime Healthcare (Coshocton, OH)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... post-graduation of an accredited school of nursing and a current state Registered Nurse license. + Grandfathered prior to April 1, 2015. Minimum 5 years post… more
- GE Vernova (Wilmington, NC)
- …regulatory certification or licensing document preparation, + Perform technical oversight, review , and verification of deliverables from suppliers to ensure their ... and matrixed functional skills and experience. + Able to handle multiple concurrent assignments and priorities. + Adaptive with continuous learning and improvement… more