- HCA Healthcare (Portsmouth, NH)
- …Degree required + 1-3 years related experience + New Hampshire Registered Nurse license or valid compact RN license preferred, not required **At** Portsmouth ... identify unexpected mortality, complications, provide comparative data through various software programs, peer review cases * Performs basic data analysis and… more
- UPMC (Mechanicsburg, PA)
- …Ostomy certification preferred. + Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Registered Nurse ( RN ) + Act 31 Child Abuse Reporting with ... **Wound Care Specialist ( RN ) - UPMC West Shore**...members of the healthcare team and participates in the peer review process. Promotes change that enhances… more
- MyFlorida (St. Petersburg, FL)
- …and Excellence in all aspects of their work. The OPS Advanced Practice Registered Nurse Specialist is responsible for providing comprehensive health ... OPS ADVANCED PRACTICE RN SPECIALIST - 64952403 Date: Oct...+ Participate in quality assurance activities including meetings and peer review . + Ensure cooperation and coordination… more
- Houston Methodist (Houston, TX)
- …decision support or similar information analysis role **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact ... At Houston Methodist, the Performance Improvement Specialist is responsible for the development of performance...design to hardwire patient safety processes. + Conducts record review for performance improvement, peer review… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) responsible for promoting ... Utilization Review Nurse and Utilization Review Specialist Nurse job roles...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Molina Healthcare (Lowell, MA)
- …quality monitoring audits, credentialing and recredentialing, quality of care concerns, and peer review . * Demonstrates understanding of requirements of the ... in a managed care setting, or equivalent experience * Registered Nurse . License must be active and...health experience (depends on state/contractual requirements). * Quality auditing, peer review , and process improvement experience. *… more
- Highmark Health (Harrisburg, PA)
- …clinical documentation through concurrent, prospective, and retrospective medical record review (30%) + Facilitate modifications to clinical documentation through ... Excellent communication skills + Critical thinking skills + Certified Coding Specialist (CCS) + Certified Outpatient Clinical Documentation Improvement Specialist… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible ... for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD) treatment at… more
- Cleveland Clinic (Cleveland, OH)
- …Care certification from an accredited school/college of nursing_ + _Current license as a Registered Nurse in the State of Ohio_ + _Current OH license*_ ... Care Medicine. Fellows begin with a boot camp to review and establish the fundamentals of practice. Each week...the field of Critical Care Medicine. The Advanced Practice Registered Nurse , Certified Nurse Practitioner… more
- Community Health Systems (Franklin, TN)
- …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating...concurrent denials by submitting reconsiderations or coordinating peer -to- peer reviews. + Communicates effectively with utilization review… more