- Centene Corporation (Little Rock, AR)
- …offering competitive benefits including a fresh perspective on workplace flexibility. Clinical Review Nurse - Concurrent Review & Outpatient Services ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
- Actalent (Fort Lauderdale, FL)
- … Clinical Review Nurse Job Description As a Clinical Review Nurse , you will perform concurrent reviews to assess members' overall health, ... Experience with Interqual and Medicare + Expertise in medical, acute care, concurrent review , and prior authorization + Knowledge of managed care and patient… more
- CVS Health (Annapolis, MD)
- …required with ability to obtain additional licenses as needed. + Utilizes clinical skills to coordinate, document and communicate all aspects of the ... and administration of the utilization/benefit management function + Gathers clinical information and applies the appropriate medical necessity criteria/guideline,… more
- Actalent (Atlanta, GA)
- Job Title: Clinical Review NurseJob Description: The Review Nurse will be responsible for reviewing approximately 20 cases a day to assess medical ... successful completion of cases. Essential Skills + Experience in utilization management, concurrent review , prior authorization, utilization review , case… more
- Children's Mercy Kansas City (Kansas City, MO)
- …can improve the lives of children beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise, ... authorization per contracts for medically appropriate level of care. Manages concurrent clinical denials through completion of verbal reconsideration process.… more
- Actalent (Miami, FL)
- Urgent Hiring for "Remote Clinical Review Nurses" Job Description: + Review approximately 20 cases a day for medical necessity. + Advocate for and protect ... other and complete cases. Qualifications: + 2+ years of utilization management, concurrent review , prior authorization, utilization review , case management,… more
- Northwell Health (Lake Success, NY)
- … clinical documentation in the patient's medical record through a concurrent review process throughout the patient's inpatient stay. 4.Requests clarification ... of clinical documentation from the physician(s) on a ...date. *Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications… more
- Dignity Health (Carmichael, CA)
- **Responsibilities** **Day Per Diem Utilization Review Registered Nurse - Onsite Campus Position** The **Utilization Review RN** is responsible for the ... Utilization Review product(s) used + Proficient in application of clinical guidelines (MCG/InterQual) preferred + Knowledge of managed care and payer environment… more
- LifePoint Health (Hickory, NC)
- *Registered Nurse (RN), Clinical Case Manager* PRN * * *Your experience matters* At Frye Regional Medical Center, we are driven by a profound commitment to ... to care. * Coordinates changes to the care plan as needed. *6. Utilization Review & Documentation** Performs admission and concurrent medical record reviews. *… 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 ... Job Summary The Clinical Documentation Improvement Program (CDI) is designed to...Dayshift; Monday through Friday. Candidates must hold a Registered Nurse license in Pennsylvania or a Multistate License. A… more
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