- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... use of services. Under the general supervision of the Director and/or Manager/ Supervisor of Medical Management, and in collaboration with the interdisciplinary team,… more
- HCA Healthcare (Houston, TX)
- …appropriate bed placement based on level of care + Conducts admission and concurrent medical record review using specific indicators and InterQual criteria in ... us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits** HCA Houston Healthcare… more
- CareFirst (Baltimore, MD)
- …Navigator RNs. Utilizes MCG to act as a resource for the nurses to conduct concurrent review for medical necessity and appropriate level of care for Commercial ... Management. + Oversees associates conducting care coordination activities including concurrent review utilizing MCG. Collaborates with CareFirst medical… more
- Centene Corporation (Sacramento, CA)
- …a fresh perspective on workplace flexibility. **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical ... between utilization management team, members, and providers + Monitors prior authorization, concurrent review , and/or retrospective clinical review nurses… more
- BrightSpring Health Services (Austin, TX)
- …Registered Professional Nurse + Excellent communicator with ability to handle concurrent tasks and responsibilities + Ability to travel within assigned area + ... meetings + Chairing committees as appropriate, safety, infection control, incident review , and human rights committees + Facilitating communication and serving as… more
- Mount Sinai Health System (New York, NY)
- …/ appeals as specified by Insurance / State & Federal regulation. + Enters concurrent review information for Review Nurses in Allscripts + Obtains/Prepares ... identifies location and distribute to appropriate departments + Monitors Concurrent Nurse denial phone calls for UM...of the hospital staff and extended community. + Notifies Supervisor of obstacles / problems affecting the completion of… more
- UNC Health Care (Goldsboro, NC)
- …on all selected admissions, consistently meeting established productivity targets for CDI record review . 7. Informs direct supervisor or indirect supervisor ... as needed. 3. Works with Clinicians and Coders to successfully implement documentation review for MS-DRG and AP-DRG payers on assigned Hospital Units. 4. Utilizes… more
- Bassett Healthcare (Oneonta, NY)
- …best quality of life possible. What you'll do Working under the supervision of the Nurse Manager of Care Management, the Registered Nurse Care Manager serves in ... patients receive quality, efficient, and cost-effective healthcare services. The Nurse Care Manager assesses, plans, implements, coordinates, monitors, and evaluates… more
- University of Michigan (Ann Arbor, MI)
- …and care of their children. The Pediatric Cardiothoracic Intensive Care Unit nurse cares for patients in a technology-intensive environment, including ECMO, CRRT, ... in Nursing staff development programs and workshops. + Participate in a concurrent and retrospective evaluation of patient care consistent with the hospital quality… more
- St. Luke's University Health Network (Allentown, PA)
- …for health care. The Clinical Documentation Specialist is responsible for the review of inpatient medical records to facilitate the accurate representation of the ... severity of illness. This involves extensive record review , interaction with physicians, HIM professionals and nursing staff. Active participation in team meetings… more