- Children's Mercy Kansas City (Kansas City, MO)
- …1-2 years experience + Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon ... review functions utilizing InterQual and/or MCG screening guidelines, and clinical denials/ appeals oversight. Participates in department and...hire + One of the following: Licensed RN - Kansas, Registered Nurse … more
- Nuvance Health (Danbury, CT)
- …or a related field preferred * Current licensure as a registered nurse ( RN ) * Minimum of 5 years of clinical experience in an acute care setting * ... and operational oversight for a team of utilization review staff, denials and appeals specialists, non- clinical support staff while partnering with local case… more
- Mount Sinai Health System (New York, NY)
- …for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission). ... **Job Description** ** RN /Case Manager MSH Case Management FT Days** The...with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the… more
- Mount Sinai Health System (New York, NY)
- …for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission). ... **Job Description** ** RN /Case Manager Inpatient Mount Sinai West FT Days...with physicians and managed care companies on concurrent denial appeals 5. Communicates clinical information to the… more
- Select Medical (Dallas, TX)
- …and valid state licensure or eligibility for state licensure as a Registered Nurse , Physical Therapist, Occupational Therapist, or Speech Language Pathologist ... Medical & Baylor Scott & White Health Dallas, TX ** Clinical Liaison ( RN , OT, PT, or SLP)**...Obtaining insurance approvals and authorizations, as well as facilitating appeals for patients + Demonstrates positive referrer satisfaction and… more
- US Tech Solutions (Columbia, SC)
- …+ NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical skills Behavioral Health or infusion therapy ... of business. Previous Medicare experience and /or UR experience/Process Appeals requests/can have experience in either Utilization management or...the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse … more
- Trinity Health (Des Moines, IA)
- …Join the MercyOne Family! We are looking to hire a RN Clinical Integration Specialist. The purpose of the ... and Medicaid Services (CMS), Iowa Department of Inspections and Appeals (IDIA), The Joint Commission (TJC),etc.), in conjunction with...Day Shift **General Requirements:** + Iowa licensure as a Registered Nurse . + Member of a professional… more
- Whidbey General Hospital (Coupeville, WA)
- …Centers: In the absence of, or in collaboration with, the Medical Oncology Practice Registered Nurse : + Act as a liaison, navigator and care coordinator between ... a key part in ensuring safe, timely, and effective care through strong communication, clinical judgment, and team collaboration. The RN - Oncology Navigator Care… more
- Beth Israel Lahey Health (Plymouth, MA)
- …concurrent and retrospective reviews for level of care and continued stay * Lead appeals of clinical denials and collaborate with physician advisors * Coordinate ... and insurers * Collect data and support denial prevention strategies * Integrate clinical and reimbursement knowledge for optimal outcomes ** RN Case Manager -… more
- Sharp HealthCare (La Mesa, CA)
- …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA...will participate in venues to reduce barriers to discharge.The RN CM Collaborates with Clinical Resource Coordinators… more