- Houston Methodist (The Woodlands, TX)
- …assigned patient population, under the direct supervision of a Physician, APP and/or Registered Nurse . This position oversees appropriate scope of practice, (ie ... patients visiting the clinic under the direct supervision of a Physician, Registered Nurse , or clinic leadership procedures. Complete pre-visit planning workflow… more
- WMCHealth (Poughkeepsie, NY)
- …related to medical staff PI + Screens cases to identify issues for physician review , using criteria established by the medical staff and the NYS DOH. + ... a potential lawsuit, etc.) and alerts the department director, medical staff leadership, and claims manager. +...+ BSN preferred. LICENSES/CERTIFICATIONS Licensed in NYS as a Registered Professional Nurse OTHER + If applicable,… more
- Elevance Health (Dearborn, MI)
- …Give referral and/or make referral appointment as circumstances warrant. + Review for medical appropriateness psychiatric/substance abuse cases utilizing ... practice that is relevant to the clinical area under review . + Provide reviews for predetermination of medical...+ Conduct business in a professional manner. + Troubleshoot claims issues. + Investigate and research to resolve customer… more
- US Tech Solutions (Columbia, SC)
- …to elicit behavior change and increase member program engagement. + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate ... **Duration: 3+ Months Contract (Possible Extension)** **Job Description:** + Must be an RN in SC and have an active and unrestricted SC RN license. +… more
- Highmark Health (Pittsburgh, PA)
- …operational areas regarding issues related to supported technology. Manage utilization review , translation of foreign claims , coordination of benefits (COB), ... Allegheny General Hospital assists patients and their support systems in managing medical conditions effectively. Our team of talented Case Managers aims to… more
- Catholic Health Services (Smithtown, NY)
- …coding and billing of resident care services to maximize reimbursement. + Claim Review : Review and analyze submitted claims for accuracy and identify ... care center; 296-bed not-for-profit community hospital and a 60,000 square foot medical office building. Our nurses, physicians and support staff are devoted to… more
- Aveanna Healthcare (Miami, FL)
- RN Clinical Director of Operations 10k Sign On Bonus ApplyRefer a FriendBack Job Details Requisition #: 209130 Location: Miami, FL 33166 Category: Nursing Salary: ... plan ** Offering: 10k Sign On Bonus Position Overview: TheHome Health RN Clinical Branch Directoris directly responsible for the administrative and leadership… more
- CVS Health (Lansing, MI)
- …and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Develops ... to enhance a member's overall wellness. + Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits. + Applies clinical… more
- Aveanna Healthcare (Brandon, FL)
- Home Health RN Executive Director ApplyRefer a FriendBack Job Details Requisition #: 209054 Location: Brandon, FL 33509 Category: Nursing Salary: $90,000.00 - ... * Plan and implement branch growth strategies * Thorough review of financial statements, activity reports, and other performance...if internal billing and collection efforts to generate clean claims * Perform other duties as assigned Why Join… more
- Aveanna Healthcare (Deland, FL)
- Home Health RN Executive Director of Operations ApplyRefer a FriendBack Job Details Requisition #: 208819 Location: Deland, FL 32720 Category: Nursing Salary: ... * Plan and implement branch growth strategies * Thorough review of financial statements, activity reports, and other performance...if internal billing and collection efforts to generate clean claims Aveanna Healthcare Offers: * 401(k) with match *… more