- Ventura County (Ventura, CA)
- …patient-centered care. Under general direction, the Senior Medical Management Nurse is responsible for performing utilization review , case management, and ... Senior Medical Management Nurse - VCHCP...are not limited to the following: + Performs utilization review with pre-certification, concurrent , retrospective, out of… more
- Geisinger (Danville, PA)
- …provided. The core of the program uses highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to be coded ... 40 hours weekly; Dayshift; Monday through Friday. Candidates must hold a Registered Nurse license in Pennsylvania or a Multistate License. A minimum of 3 years… more
- Centene Corporation (Jefferson City, MO)
- …providers, as appropriate, for any discrepancies between prior authorization and concurrent review processes to ensure clinically appropriate determinations + ... quality of care issues, and if identified, refer to the Medical Director or provider for review and verification + Consults with senior management and healthcare… more
- Sacramento County (Sacramento, CA)
- …Employment Qualifications Minimum Qualifications Either: One year of experience as a Senior Public Health Nurse in Sacramento County service. Or: Two ... improperly rejected may request the Employment Services Division to review its decision to reject the application. If the...+ I have one year of experience as a Senior Public Health Nurse in Sacramento County… more
- Geisinger (Danville, PA)
- …PI Program and Trauma Registry. + Maintains trauma roster and updates on concurrent basis. + Summarizes concurrent daily chart rounding information into monthly ... quality improvement report and forwards initial review to leadership for secondary review and...of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE &… more
- Geisinger (Danville, PA)
- …National Healthcare Safety Network (NHSN) reporting criteria and requirements. + Performs concurrent and retrospective medical record review including review ... Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review , we're working to create a national model for...and DOH surveys. At least 2 years of Registered Nurse work experience in a hospital setting is required.… more
- Geisinger (Scranton, PA)
- …As one of the Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review , we're working to create a national model for improving health. Today, we're ... universal life and pet and legal insurance Position Details The Registered Nurse Care Manager works with physician and multidisciplinary team members to develop… more
- Geisinger (Danville, PA)
- …provided. The core of the program uses highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to be coded ... DRG assignment, risk of mortality, severity of illness; and initiate documentation of the review . + Pursues a subsequent review of records every 3 days to… more
- Houston Methodist (Katy, TX)
- …completed timely to avoid denials or billing delays. Provides oversight for the concurrent denials and short stay review process in collaboration with physician ... At Houston Methodist, the Director Centralized Utilization Review (UR) position is responsible for strategic, administrative, and operational leadership for the… more
- Sacramento County (Sacramento, CA)
- Senior Mental Health Worker-Licensed Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/1036656) Apply Senior Mental Health Worker-Licensed ... plans with little direct supervision; provide direction to and review the work of assigned staff. + Establish and...the State of California to practice as a Registered Nurse , Vocational Nurse or Psychiatric Technician AND… more