- Christus Health (Alexandria, LA)
- …participates in their resolution. Coordinates with quality department by: providing concurrent review for core measures documentation, providing retrospective ... make your application promptly. Summary: The Clinical Documentation Registered Nurse collaborates extensively with physicians, nursing staff, other patient… more
- Luminis Health (Lanham, MD)
- Position Objective: Conducts concurrent and retrospective chart review for clinical, financial, and resource utilization information. Provides intervention and ... and denial of payment. Essential Job Duties: 1. Chart Review : Reviews the medical record by applying utilization... : Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization;… more
- AlohaCare (Honolulu, HI)
- …and HEDIS/STARS metrics initiatives. Oversees Utilization Management toward an effective concurrent review process and case management across the continuum ... clinical services and quality outcomes. Oversees Utilization Management toward an effective concurrent review process and case management across the continuum of… more
- Direct Staffing Inc (Bay Shore, NY)
- …of the level of clinical services and patient severity through extensive concurrent interaction with physicians, nursing staff and other caregivers, case management ... DRG classifications or other categories of admissions. ◦Ensures chart review within 48-72 hours of admission to meet criteria....preferred. *Current license to practice as a Registered Professional Nurse in New York State. *Minimum of seven (7)… more
- Integrated Resources Inc. (Miami, FL)
- …looking for 3 years of Inpatient Medical experience, 3 years of Utilization experience, Concurrent Review experience and HMO exp. A strong candidate would be ... Interqual. License and Educational requirement: LPN - Licensed Practical Nurse . An Associate's Degree is required for the LPN...required for the LPN and the RN - Registered Nurse - A Bachelor's Degree is required for the… more
- Ll Oefentherapie (Helena, MT)
- …(ECD) alignments, Critical Care workflow implementation, Multi-Disciplinary Rounding, and various nurse chart review and documentation optimizations. The ideal ... and patient care improvements. Manage the nursing needs for multiple concurrent optimization projects, from requirements analysis and solution design to testing,… more
- Turner Construction Company (Saddle Brook, NJ)
- …knowledge of workers' compensation policy and manage incidents, and dispatch nurse case managers as necessary. Collaborate closely with Risk Management leadership ... and pursued and manage lien recovery on case-by-case basis. Participate in claims review process and monitor claims handling process by carriers and TPAs; provide… more
- Centene Corporation (Des Moines, IA)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- Cleveland Clinic (Cleveland, OH)
- …with one of the most respected healthcare organizations in the world. As a Concurrent Denial Nurse , you will support the Utilization Management Department by ... criteria is met. We are looking for a Registered Nurse who is a subject matter expert in utilization...to the department in general and the hospital. + Review and analyze concurrent and retrospective clinical… more
- Cedars-Sinai (Los Angeles, CA)
- …Hospitals. Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse - Medicare Short Stay & Concurrent Denials supports post-discharge ... Short Stay cases and assists with real-time management of concurrent payer denials. + This role ensures timely, accurate,...Coordination **Req ID** : 14355 **Working Title** : Registered Nurse -Utilization Review Case Manager - 8… more
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