- St. Luke's University Health Network (Allentown, PA)
- …appropriate to the age of the patient treated. + Performs admission review on all inpatients. Attends daily patient rounds and shares professional knowledge, ... of patient care management. + Facilitates insurance authorization, pre-certification, and concurrent reviews for assigned patients. + Maintains clinical records of… more
- Highmark Health (Pittsburgh, PA)
- …operational areas regarding issues related to supported technology. Manage utilization review , translation of foreign claims, coordination of benefits (COB), and ... other members of the interdisciplinary team. + Completes and documents admission, concurrent , and discharge reviews of all inpatients and selected outpatients. +… more
- Elevance Health (Independence, OH)
- …complex case types 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 limited ... less experienced staff. + Conducts and may approve precertification, concurrent , retrospective, out-of-network, and/or appropriateness of treatment setting reviews… more
- Health Care Service Corporation (Downers Grove, IL)
- …professional development. **Job Summary** This position is responsible for performing concurrent review in accordance with approved departmental guidelines; ... within the scope of their benefit plan. **Required Job Qualifications:** + Registered Nurse (RN) with current, valid, unrestricted license to practice in state of… more
- HCA Healthcare (Trinity, FL)
- …staff and board members on analysis of risk assessment, historical and concurrent occurrence and claims data and national trends. .You will ensure responsibility ... field required; Master's Degree preferred .Current Florida licensure as a Registered Nurse preferred _**If serving as facility's primary Risk Manager, VP must have… more
- HCA Healthcare (Englewood, CO)
- …with the efficacious and cost effective utilization of resources. Through concurrent clinical case management, patients will be assessed to determine appropriateness ... licensure in the State of Colorado as a Registered Nurse , or current active multistate nursing licensure, or LCSW...apply for our Social Work Manager opening. We promptly review all applications. Highly qualified candidates will be contacted… more
- Baylor Scott & White Health (Dallas, TX)
- …executives and key stake holders. **Essential Functions of the Role** + Performs concurrent and retrospective medical record review to investigate quality and/or ... tasks to meet desired deadlines. + Licensed clinician such as nurse , physical therapist, occupational therapist, dietitian, respiratory therapist, etc. preferred.… more
- Prime Healthcare (Redding, CA)
- …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.2. Grandfathered prior to April 1, 2015. Minimum 5 years post… more
- Prime Healthcare (Evanston, IL)
- …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 2. 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