- Trinity Health (Livonia, MI)
- …Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** Work Remote Position At the direction of the Regional Manager, Clinical Documentation ... to enhance clinical and coding skill sets and optimal utilization of the 3M CDI software. Responsible for scheduling...direct reports perform clinical validation as part of the review process and remain current on CDI strategies. Maintains… more
- Trinity Health (Livonia, MI)
- …Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** Work Remote Position Responsible for directing Clinical Documentation Integrity (CDI) activities ... to enhance clinical and coding skill sets and optimal utilization of 3M CDI software. Analyzes data to determine...direct reports perform clinical validation as part of the review process and remain current on CDI strategies. Uses… more
- GE Vernova (Wilmington, NC)
- …and engineering management advised of project progress, performance, and resource utilization with particular attention to delays, adverse trends, errors and ... Design Reviews as required for successful completion of the project + Review engineering performance on the project to ensure quality, conformance with design… more
- Providence (Seward, AK)
- …qualifications:** + 3 years Clinical nursing experience. + 1 year Utilization Management- review and Discharge-planning experience. + Experience associated with ... empower them. **This Care Manager RN position is a Remote work opportunity, if you reside within the State...accredited school of Nursing. + Upon hire: Alaska Registered Nurse License. + 2 years Clinical nursing experience. **Preferred… more
- CareFirst (Baltimore, MD)
- …related experience working in Care Management, Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct patient care ... and/or social determinant of health needs. Engage members and providers to review and clarify treatment plans ensuring alignment with medical benefits and policies… more
- Molina Healthcare (San Antonio, TX)
- For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of ... on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member… more
- Community Health Systems (Naples, FL)
- …collaborative care planning. + Ensures accurate and timely documentation of utilization review , discharge planning activities, and patient interactions in ... **THIS IS NOT A REMOTE POSITION** **Benefits** ** Tuition Reimbursement ** 401K...years of clinical nursing experience required + Experience in utilization review , case management, or discharge planning… more
- ChenMed (Philadelphia, PA)
- …assess and record patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with inpatient staff for possible ... on-site at an assigned hospital daily from 9am-3pm, working remote for the remaining hours. The Acute Care Manager,...required + A minimum of one (1) year of utilization review and/or case management, home health,… more
- AmeriHealth Caritas (Philadelphia, PA)
- …Review Home Modification Team and staff members within the LTSS Review Utilization Management Department. Responsibilities include providing technical and ... of new and/or revised work processes, policies and procedures relating to LTSS Utilization Review . + Accurately answers questions regarding CHC benefits for… more
- CenterWell (Brooklyn Park, MN)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... Location** : Brooklyn Park, MN **This is not a remote or work-from-home position. This position requires you to...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more