- Chenega Corporation (Rockville, MD)
- …the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States . + Must be able to travel to clients location occasionally ... **Chenega Professional Services Strategic Business Unit** company, is looking for a Nurse Practitioner-Contract Medical Reviewer (CMR) to support the Department… more
- AmeriHealth Caritas (Washington, DC)
- …When necessary, cases are escalated to the Medical Director for further review . The reviewer independently applies medical and behavioral health guidelines ... on clinical criteria. Using professional judgment, the Clinical Care Reviewer assesses the appropriateness of services, identifies care coordination opportunities,… more
- Zelis (St. Petersburg, FL)
- …maintain claim review content, including but not limited to DRG Reviewer Rationales, DRG Clinical Validation Policies and Dispute Rationales + Perform regulatory ... Done. So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across...are. Position Overview At Zelis, the DRG Clinical Dispute Reviewer role is responsible for the resolution of facility… more
- Zelis (FL)
- …Zelis, we Get Stuff Done. So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare ... interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay… more
- SSM Health (OK)
- …of Safety and Professional Services **Work Shift:** PRN / Per Diem Shift ( United States of America) **Job Type:** Employee **Department:** 8746010033 Sys ... the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate diagnosis review group (DRG) assignment, risk of mortality (ROM), and severity of… more
- SSM Health (MO)
- …Wisconsin Department of Safety and Professional Services **Work Shift:** Day Shift ( United States of America) **Job Type:** Employee **Department:** 8746010033 ... to clinical staff regarding these requirements during the concurrent record review process. + Maintains knowledge of mortality models, observed rate/expected rate… more
- PruittHealth (Columbia, SC)
- **RN experienced with OASIS and certified ICD 10 Reviewer ** **- HOME HEALTH SERVICES** **Must have ICD-10 Certification** **Join the PruittHealth @Home family, where ... CERTIFICATION, AND EDUCATIONAL REQUIREMENTS** + Current, active, and unrestricted Registered Nurse (RN) licensure in the state of practice **Family Makes … more
- Zelis (NJ)
- …Zelis, we Get Stuff Done. So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare ... Zelis standards regarding privacy What you'll bring to Zelis: + Registered Nurse licensure preferred + Inpatient Coding Certification required (ie, CCS, CIC, RHIA,… more
- Katmai (Usaf Academy, CO)
- …same duties as those required of any military or government civil service nurse of similar experience and in similar duty assignments. **ESSENTIAL DUTIES & ... and communicate with facility staff members to facilitate patient care. + Accurately review and confirm completeness of patient chart and report any abnormalities to… more
- HCA Healthcare (Orlando, FL)
- …front line, empathetic for patients. At UCF Lake Nona Hospital our nurses set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...coordinate education and communication related to regulator updates. **CLINICAL REVIEWER RESPONSIBILITIES** : + MBS clinical reviewer … more