- 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
- George C. Grape Community Hospital (Hamburg, IA)
- Quality/Utilization Review Nurse Position Summary: The Quality/Utilization Review Nurse is responsible for evaluating the medical necessity, ... infection prevention protocols and regulatory compliance. Key Responsibilities: * Utilization Review : o Conduct concurrent and retrospective reviews of patient… more
- TEKsystems (West Des Moines, IA)
- …required. + The Clinical Documentation Specialist (CDS) is responsible for performing concurrent review of medical records to ensure complete and accurate ... departments as needed and directed by CDI leaders. Skills Required: Registered Nurse Certification Clinical Documentation Integrity RN experience in an adult… more
- Oracle (Des Moines, IA)
- …(ECD) alignments, Critical Care workflow implementation, Multi-Disciplinary Rounding, and various nurse chart review and documentation optimizations. The ideal ... of analysts providing support for operationally required changes and enhancements to clinical applications, and aa group of analysts leading projects that will… more
- Molina Healthcare (Iowa City, IA)
- …requests in timely support of nurse reviewers, reviews cases requiring concurrent review and manages the denial process. * Monitors appropriate care ... for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. * Provides leadership and consultation… more
- Great River Health (West Burlington, IA)
- …(United States of America) Required Qualifications: Acute Inpatient Rehabilitation Department1. Review potential admits with Clinical Liaison to assess for ... task and manage multiple priorities + Accurate input of data and review of quality metrics. + Demonstrate an understanding of medical complications, co-morbidities,… more