- International Medical Group (Indianapolis, IN)
- …an active RN license in good standing in Indiana. + Location: Hybrid or Remote working options. + Corporate office is in Indianapolis, IN. + Relocation Expenses ... of the use of health care services, procedures, and facilities for utilization review and /or /evacuation/repatriation. Work as a liaison between the Insured, the… more
- BrightSpring Health Services (Mount Laurel, NJ)
- …Registered Professional Nurse + Excellent communicator with ability to handle concurrent tasks and responsibilities + Ability to travel within assigned area + ... of health care within all programs. + Travels to programs to review individual records, collaborate with para-professional team members, and evaluate nursing… more
- Centene Corporation (San Diego, CA)
- …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... Remote - TX** **Position Purpose:** Performs a clinical review and assesses care related to mental health and...+ Experience working with providers and healthcare teams to review care services, precertification, concurrent review… more
- Providence (Beaverton, OR)
- …Planning, Coordination of Outpatient Care) + Utilization Management Experience (EX. Concurrent Review , Prior Authorization, Medical Audits, Appeals or ... nearing end of life + Care management services include: nurse education, care coordination and general assistance with managing...care to our members **Providence Health Plan welcomes 100% remote work to residents who reside in the following… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Purpose** Work Remote Position (Pay Range: $24.5303-$36.7954) Provides oversight & support of ... services. Responsible for charge capture in Revenue Integrity assigned areas. Review 's chart, including nursing notes, physician orders, progress notes, and surgical… more
- Centene Corporation (Honolulu, HI)
- …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... organization offering competitive benefits including a fresh perspective on workplace flexibility. Remote Position. Must Reside in Hawaii Registered Nurse (RN)… more
- Beth Israel Lahey Health (Burlington, MA)
- …a job, you're making a difference in people's lives.** **This position is remote . Candidates must be local to New England States for consideration** The Clinical ... Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the appropriate identification of diagnoses, conditions, and/or procedures that are… 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
- SSM Health (MO)
- …and provides feedback to clinical staff regarding these requirements during the concurrent record review process. + Maintains knowledge of mortality models, ... **It's more than a career, it's a calling.** MO- REMOTE **Worker Type:** Regular **Job Summary:** Performs as...rate/expected rate (O/E ratios), industry trends, variable and diagnosis review group (DRG) frequency. + Serves as a liaison… more
- Sharp HealthCare (San Diego, CA)
- …position, and employer business practices. **What You Will Do** Perform admission and concurrent review of patients, based upon needs regardless of payor ... patients.Interfaces with Business Office regarding ongoing certification of stay.Provides concurrent and retro UR reviews to Review Organizations.Identifies… more