- UPMC (Harrisburg, PA)
- …the most specialized and rewarding areas of pediatric medicine. Purpose: The Programmatic Nurse Specialist , a professional registered nurse , has the ... the nursing process. In collaboration with the health care team, the Programmatic Nurse Specialist applies expert clinical knowledge and skills to achieve… more
- Cedars-Sinai (Los Angeles, CA)
- …Experience: A minimum of 5 years of experience in Acute Clinical Care, Utilization Review , Coding, or Case Management required Working knowledge of Joint ... for Hiring. **Req ID** : 10457 **Working Title** : Registered Nurse - Clinical Documentation Specialist - 8 Hour Days **Department** : CSRC CDI Services… more
- Ascension Health (Austin, TX)
- …process. + Serve as content specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation. + ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
- PeaceHealth (Bellingham, WA)
- …of psychiatric diagnostics. + Preferred: Third party reimbursement knowledge. + Preferred: Utilization Review experience, someone who can talk to providers. ... **Description** PeaceHealth is seeking a RN Admissions/ Utilization Behavioral Health - Care Management for a...in state of practice + Preferred: Psychiatric/Mental Health Clinical Nurse Specialist **Skills** + Strong psychiatric nursing… more
- Tufts Medicine (Melrose, MA)
- …role is essential in developing and maintaining an infrastructure for the systematic review and management of complex patients. The position will work closely with ... managers, TMIN Practice Optimization Coaches (POMs) and primary care providers to review patient records, analyze data, and identify practice and patient outlier … more
- Hospice of Michigan (Southfield, MI)
- …work with minimal supervision. + Requires knowledge of quality assessment and utilization review functions, principles and practices. + Theoretical and practical ... personnel on the QAPI plan, and team development. + Performs clinical record review activities for data collection. + Compiles, analyzes, trends and reports quality… more
- Houston Methodist (Sugar Land, TX)
- …Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management and ... Seven years clinical nursing/patient care experience which includes three years in utilization review , case management or equivalent revenue cycle clinical role… more
- Trinity Health (Syracuse, NY)
- …requirements for Utilization Management and works collaboratively with Utilization Management/Concurrent Review Nurse , physicians, staff and ... identification of possible concurrent denials, forwards information to the appropriate Utilization Management/Concurrent Review Nurse within identified… more
- HCA Healthcare (Dallas, TX)
- …acute inpatient rehabilitation services prior to returning home. The Clinical Rehabilitation Specialist will review these patients daily until they have strong ... commitments to referral sources. Develops a call-plan to prioritize utilization of time. + Assists in developing the annual...we encourage you to apply for our Clinical Rehab Specialist opening. We promptly review all applications.… more
- HCA Healthcare (Nashville, TN)
- …treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile ... any other healthcare provider. We are seeking a(an) Assessment Specialist PRN to join our healthcare family. **Benefits** TriStar...patients in regard to managed care organizations + Conducts utilization review for managed care cases in… more