- Sanford Health (Rapid City, SD)
- …preferred. Experience in medical necessity review preferred. Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a high-impact, data-driven program that… more
- San Antonio Behavioral Health (San Antonio, TX)
- …May consult with staff as needed. Essential Duties: + Collaborate and set standards with registered nurse ( RN ) case managers (CMs) and outcome managers to ... The Utilization Review Coordinator conducts utilization reviews to determine if...denials and respond appropriately; ie facilitate Physician to Physician appeals when appropriate and assist with construction of appeal… more
- State of Colorado (Denver, CO)
- …of clients and patients through observations, interviews, and record reviews. Serving as the registered nurse member of the survey team , you will apply your ... compliance with state and federal regulations, conduct medication observations, and review nursing practices. You will also investigate serious incidents and… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …as necessary collaboration/supervision agreements with Advance Practice Professionals (Certified Registered Nurse Practitioners or Physician Assistants) and ... and Statistical Manual of Mental Disorders, written treatment orders, admissions on-call review for all legal commitment status documents and review and… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …as necessary collaboration/supervision agreements with Advance Practice Professionals (Certified Registered Nurse Practitioners or Physician Assistants) and ... history and physical examination, either written or dictated. This includes a review of the immunization status, allergies, past history, family history and… more
- Molina Healthcare (Madison, WI)
- …or equivalent combination of relevant education and experience. * Advanced Practice Registered Nurse (APRN) license. License must be active and unrestricted ... the chief medical officer. * Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review and manages the… more
- Community Wellness Partners (Oswego, NY)
- …or more than forty (40) hours per week. QUALIFICATIONS: 1. Current NYS Licensed Registered Nurse 2. Knowledge of MDS 3.0, CAA's, Medicare and Medicaid Guidelines ... WAGE RATE - $75K - $85K/Year GENERAL DESCRIPTION: MDS (Minimum Data Set) nurse collects and assesses information for the health and well-being resident in Medicare… more
- HCA Healthcare (Tampa, FL)
- …cycle. **What qualifications you will need:** + Bachelor's degree required + Registered Nurse or Certified Professional Coder (CPC) required + Denial/Appeal ... communication assistance to the SSC (Shared Services Center) including appeals , CIV, NOA, and hospital PADs as needed. +...+ Provides for weekly monitoring and dashboard development and review . + Interacts with payers as required or as… more
- Calvary Hospital (Bronx, NY)
- …year Requirements QUALIFICATIONS: 1. Master of Nursing Degree required. 2. NYS unencumbered Registered Nurse License required. 3. Ten (10) to fifteen (15) years ... to facilitate reimbursement for services provided by the Hospital. Oversees the appeals process for those cases for which reimbursement has been denied. Conducts… more
- Sacramento County (Sacramento, CA)
- …status. + None + Basic Life Support (BLS) / Cardiopulmonary Resuscitation (CPR) + Registered Nurse in California + Advanced Cardiac Life Support + Certified ... Licensed Vocational Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448956) Apply Licensed Vocational Nurse D/CF Salary… more