- Centene Corporation (Tallahassee, FL)
- …on workplace flexibility. **Must Reside in Florida!** **Centene is Hiring!** **We're looking for a Remote Concurrent Review Nurse to support our Medicaid ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a CDI Concurrent Review and Query Specialist? At HCA Healthcare, you come first. HCA Healthcare ... **Description** This is a fully remote role but you must live within 60...a difference. We are looking for a dedicated CDI Concurrent Review and Query Specialist like you… more
- Cognizant (Annapolis, MD)
- …Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical ... as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,...Based on this role's business requirements, this is a remote position open to qualified applicants in United States.… more
- CVS Health (Phoenix, AZ)
- …outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or prior authorization. + Strong decision-making skills and ... members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this role, you'll be at the forefront of… more
- Providence (Mission Hills, CA)
- **Description** **RN Utilization Review at Providence Holy Cross Medical Center in Mission Hills, CA. This position is Part- time and will work 8-hour, Day shifts.** ... of US hospitals are four times designated. Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and… more
- Veterans Affairs, Veterans Health Administration (Las Vegas, NV)
- …on Service Connection (SC), non-SC, Special Authority (SA), precertification, prospective review , concurrent review , denial management, retrospective ... Summary The Revenue Utilization Review (RUR) nurse is under the...Must have ability to report to Las Vegas, NV Remote : This is not a remote position.… more
- Henry Ford Health System (Warren, MI)
- …and skill to reduce significant financial risk and exposure caused by concurrent and retrospective denial of payments for services provided. Through continuous ... and critical thinking to maximize reimbursement. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse required. + Minimum 3-5 years of clinical experience required. +… more
- Actalent (Sacramento, CA)
- …Certified Case Manager (CCM), CPUR, or CPHM credential preferred. + Background in concurrent review or inpatient census oversight preferred. + Strong critical ... Remote Licensed Vocational Nurse (LVN) Fully...Conduct in-person hospital rounds 2-3 days per week, telephonic review and participate in interdisciplinary case reviews + Escalate… more
- Vitalief (Philadelphia, PA)
- …and grow sustainably. The Role We are seeking an experienced Clinical Research Nurse to join our exceptional team as a full-time Vitalief employee. In this ... plans. + Hybrid schedule : 4 days on-site (Philadelphia), 1 day remote weekly. + Market-competitive salary , commensurate with experience. Responsibilities: + Under… 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 ... PA, but may allow for some days to be remote in the future. The role is full-time, 40...mortality, severity of illness; and initiate documentation of the review . + Pursues a subsequent review of… more