- Centene Corporation (Indianapolis, IN)
- …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
- Blue KC (MO)
- …**Employee discount program** **Job Description Summary:** Utilizes a collaborative review process of benefits, minimally necessary clinical information ... benefits and/or individual consideration reimbursement allowables using varied and broad clinical expertise. Acts as a member and provider advocate promoting and… more
- Montana State University-Northern (Havre, MT)
- …is ten. The CRRN is responsible for the students and must have not have concurrent clinical responsibilities. The CRRN may also be assigned to monitor students ... Clinical Resource Registered Nurse (CRRN) part-time...position including any supplementary documentation and questions you should review before applying for the opening. To apply for… more
- Geisinger (Danville, PA)
- …impact. Job Duties The RN Clinical Access Specialist performs initial, concurrent and retrospective medical record review to determine medical necessity for ... to state, federal and third party payer certification requirements for initial, concurrent and retrospective medical record review for medical necessity and… 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 ... work on site position located in Danville, Pennsylvania. The Clinical Documentation Improvement Program (CDI) is designed to improve...mortality, severity of illness; and initiate documentation of the review . + Pursues a subsequent review of… more
- Tufts Medicine (Lowell, MA)
- …to internal staff who have worked with EVD, IABP and Impella patients. The Clinical Leader of ICU-G is a Registered Nurse with responsibility and accountability ... including: setting expectations, continuing education, credentialing, performance appraisals, auditing, concurrent monitoring, utilization review , risk management and… more
- UPMC (Hanover, PA)
- …delays in discharge. Documents all Avoidable Days in CANOPY system. + Performs clinical review on admission and/or continued stay using InterQual criteria to ... **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a rotating… more
- Beth Israel Lahey Health (Burlington, MA)
- …being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for ... a Registered Nurse (RN), Massachusetts + Three years of recent clinical or utilization management experience _Preferred:_ + Bachelor's degree in nursing or… more
- Logan Health (Kalispell, MT)
- …are utilized by the assigned area(s). Participates in the development and concurrent review of policies and procedures. Assures appropriate staff training ... This position provides clinical oversight to the patient care team on...on the assigned area(s) according to the Montana State Nurse Practice Act, and the State Board of Nursing… more
- HCA Healthcare (Nashville, TN)
- …medical record review , validate admission status order, conduct a medical necessity review and provide clinical information to payor + Document all efforts ... sites and On base + Communicate with physicians regarding patient status, clinical documentation, and concurrent denial mitigation strategies + Practice… more