- Commonwealth Care Alliance (Boston, MA)
- …claims adjudication, clinical coding reviews for claims, settlement, claims auditing and/or utilization review required + 7+ years experience with Optum Claims ... regulations. The role will also be responsible for timely review and research, as necessary on all new and...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
- Parexel (Hartford, CT)
- …reproducible research practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable health professional credentials, ... solutions, and ensure high-quality, compliant data. + Use surveillance tools to review data at an aggregate level, identifying patterns or anomalies to ensure… more
- Atrius Health (Newton, MA)
- …and/or families to bridge the Atrius Health practice to the patient. . Conducts review of the medical record for Atrius Health adult medical or surgical hospitalized ... of patient within 24 - 48 hours (business days of admission). . Subsequent review /progress note at least every 7 days or accompanying a change in condition/plan. .… more
- HCA Healthcare (Austin, TX)
- …and retrospective review of patient medical records for purposes of utilization review , care coordination compliance with requirements of external review ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...required experience: Minimum of at least two years of RN experience.** **EDUCATION REQUIRED** + **Associate's Degree-Major: Nursing** +… more
- Fresenius Medical Center (Anaheim, CA)
- …priority management, and recommendation and implementation changes of current methods. + Review and comply with the Code of Business Conduct and all applicable ... of service being provided to the customers. + In-depth review with direct reports on the data retrieved from...for improvement eg Compliance, Billing, and Quality Indicators. + Utilization of data to better understand their business unit(s)… more
- HCA Healthcare (Austin, TX)
- …and retrospective review of patient medical records for purposes of utilization review , care coordination compliance with requirements of external review ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...required experience: Minimum of at least two years of RN experience.** **EDUCATION REQUIRED** + **Associate's Degree-Major: Nursing** +… more
- University of Southern California (Arcadia, CA)
- …requirements impact DRG assignments. + Minimum of three years' experience in clinical disciplines ( RN , MD, FMG) or utilization review /case management in an ... and other clinical staff. + Meets established productivity targets for record review and appropriate query placement. + Demonstrates working knowledge of ICD-10 CM… more
- MyFlorida (Land O' Lakes, FL)
- SENIOR LICENSED PRACTICAL NURSE - 50000083 Date: Dec 12, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 865263 Agency: Veterans Affairs Working Title: SENIOR LICENSED PRACTICAL NURSE - 50000083 Pay Plan: Career Service Position Number: 50000083 Salary:… more
- HCA Healthcare (Denver, CO)
- …satisfaction and personal growth, we encourage you to apply for our Operating Room Nurse PRN opening. We review all applications. Qualified candidates will be ... have the PRN career opportunities as an Operating Room Nurse PRN you want with your current employer? We...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- University of Miami (North Miami, FL)
- …position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Accountabilities ... and applicable certifications and professional practice standards. Responsible for the utilization and maintenance of appropriate nursing care plans and assessment… more
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