- Tenet Healthcare (Detroit, MI)
- …no authorizations in the case management system Follows the payor dispute processes utilizing secondary medical review , peer to peer and payor type ... based on Medical Necessity and submits case for Secondary Physician review per Tenet policy Ensures timely communication and documentation of clinical data to… more
- UPMC (Pittsburgh, PA)
- …feedback to all members of the health care team and participates in the nursing peer review process. Promotes change that enhances the quality of patient care ... is currently hiring for a Regular Full-Time Sr. Professional Staff Nurse, ONC (RN) to help support the ...Staff Nurse, ONC (RN) to help support the Medical Oncology team at the Hillman Cancer Center located… more
- Mount Sinai Health System (New York, NY)
- …evidence-based ensure and procedures. + Engages in formal and informal peer and institutional review processes. + Collaborates with interdisciplinary ... of Care), AM/PM Care, 5 Minute Sit Down, Purposeful Hourly Rounding, Medication Review , Discharge Wrap Up, and MD/RN Unit Collaboration. + Considers the patients… more
- WMCHealth (Suffern, NY)
- … review for quality or peer review . . In collaboration with Medical Staff Leadership assures timely completion of peer review activities. . ... Provides leadership for internal quality, peer review and mortality and morbidity meetings. . Participates in...components of care delivery (ie Nursing, Ancillary/Support Services, and Medical Staff Office) to ensure that a… more
- AdventHealth (Glendale Heights, IL)
- …resolution of pending denials, which have been referred to the physician for peer -to- peer review with the Medical Director of the insurance carrier. ... to the Physician Advisor or designated leader for additional review as determined by department standards. Additionally, the UM...physician advisor to avoid concurrent denials. + Collaborates with medical staff , nursing staff , payor,… more
- Covenant Health (Nashua, NH)
- …and maintains professional relationships with department team members and members of the medical staff . + Participates in assigned committees and reports out any ... Summary Conducts medical necessity reviews in accordance with the Utilization...appropriate setting and in a timely manner. + Seeks peer assistance and/or provides consultation regarding complex cases and/or… more
- Veterans Affairs, Veterans Health Administration (Detroit, MI)
- …as initiatives designed to improve overall quality through evidence-based medicine and peer review . Participates and facilitates implementation of modern care, ... notification of time-sensitive results and/or results that have major clinical significance. Medical Staff Functions: Participate in Imaging and general … more
- Catholic Health Initiatives (Garrison, ND)
- …efficiency, FMEAS, root cause analyses and medical staff improvement (eg case review for peer review , OPPE, FPPE). Participates in an integral role ... regulatory performance improvement (PI) activities for the hospital and medical staff . This role also serves as...provide case summaries and maintain the confidentiality of the peer review process. Knowledge of the techniques… more
- Veterans Affairs, Veterans Health Administration (Salisbury, NC)
- …in the continuing operation of the service line. The incumbent monitors and ensures medical staff compliance with agency regulations, medical staff ... the hospital as well as continuous quality improvement through peer review process. Is responsible for Quality...verified practice in the United States), which the local Medical Staff Executive Committee deems to have… more
- Veterans Affairs, Veterans Health Administration (Dallas, TX)
- …related activities, including attendance of PRRC staff meetings, monthly Psychology staff meetings, monthly Quality Peer Review meetings, and overall ... safety will take priority in any crisis. Consult with medical center staff regarding various patient care...compliance with Psychology peer review procedures. As with all Staff Psychologist… more