- Atlantic Health System (Morristown, NJ)
- …- Becker's Healthcare + 100 Accountable Care Organizations to Know - Becker's Hospital Review + Best Employers for Workers over 50 - AARP + Gold-Level "Well ... safety grade - its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in… more
- Northwell Health (Lake Success, NY)
- …within 5 years of employment date. *Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications ... of care provided. Responsible for concurrent inpatient medical record reviews for Medicare , Medicaid and all commercial payers. Generates queries and have follow up… more
- Alameda Health System (Alameda, CA)
- …OBRA assessments. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. Required Licenses/Certifications: ... is documented and a resolution is initiated and presented weekly at Medicare or Utilization Review meetings. **MININUM QUALIFICATIONS** : Education: Graduate… more
- Commonwealth Care Alliance (Boston, MA)
- …research, as necessary on all new and revised coding logic, related Medicare /Medicaid policies for review /approval through the Payment Integrity governance ... ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also...Optum CES and Zelis edits. + Quarterly and Annual review and research, as necessary on all new CPT… more
- New York State Civil Service (Buffalo, NY)
- …all requirements of non-competitive promotion are met.Promotional Field consists of Registered Nurse 1 Psychiatric (including all language parenthetic) ... in a health care facility regulated by Centers for Medicare and Medicaid Services Utilization Review Standards, or* Possession of a license and registration to… more
- New York State Civil Service (Bronx, NY)
- …all requirements of non-competitive promotion are met.Promotional Field consists of Registered Nurse 1 Psychiatric (including all language parenthetic) ... in a health care facility regulated by Centers for Medicare and Medicaid Services Utilization Review Standards, or* Possession of a license and registration to… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse ( RN ) who comprehensively conducts point of entry and ... in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare , Medicaid,… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager (CM) position is a registered nurse ( RN ) responsible for comprehensively planning for case management, which includes ... clinical experience + Case management experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or… more
- RWJBarnabas Health (Oceanport, NJ)
- Inpatient Coding Quality Officer III - ( Medicare )Req #:0000183242 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services ... accuracy and integrity of ICD-10-CM/PCS coding and DRG assignment for inpatient Medicare encounters. This requires critical thinking and a higher level skill set… more
- SSM Health (Fond Du Lac, WI)
- …Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) + And + Registered Nurse ( RN ) - Missouri Division of Professional Registration + ... documentation of CNA's and nursing staff. Conducts training and review of ADL's and other minimum data set related...Or + Registered Nurse ( RN ) Issued by… more