- Children's Mercy Kansas City (Kansas City, MO)
- …we can improve the lives of children beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise, ... status and continued patient stays with Attending Physician, Physician Advisor, Inpatient Nurse Care Manager, and insurance/payer. + Collaborates with Revenue… more
- Children's Mercy Kansas City (Kansas City, MO)
- …resolve issues. The High-Risk Nurse Lead is an expert at the roles of Clinical Review Nurse Care Manager and Care Coordination Case Manager and ... beyond the walls of our hospital. Overview The High-Risk Nurse Lead manages high risk administrative processes and data...final appeal outcome to identify and resolve insurance/payer issues; clinical care delivery concerns; Care … more
- Children's Mercy Kansas City (Kansas City, MO)
- …is expert at the roles of Clinical Review Case Manager and Care Coordination Nurse Case Manager and provides support to larger team in addressing and ... of children beyond the walls of our hospital. Overview The Professional Practice Nurse Care Manager Lead manages new employee orientation and ongoing… more
- Actalent (Eugene, OR)
- Job Title: Clinical Review Nurse - Prior Authorization Job Description This role involves analyzing all prior authorization requests to determine the medical ... medical team to promote quality and cost-effectiveness of medical care . Responsibilities + Perform medical necessity and clinical...+ Licensed Practical Nurse (LPN) or Registered Nurse (RN) certification. + Clinical review… more
- Actalent (Fort Lauderdale, FL)
- Job Title: Clinical Review Nurse Job...will perform concurrent reviews to assess members' overall health, review the type of care being delivered, ... + Experience with Interqual and Medicare + Expertise in medical, acute care , concurrent review , and prior authorization + Knowledge of managed care and… more
- Centene Corporation (New York, NY)
- …+ Provides feedback to leadership on opportunities to improve appropriate level of care and medically necessity based on clinical policies and guidelines + ... being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member...4 years of related experience. 2+ years of acute care experience required. Clinical knowledge and ability… more
- Cleveland Clinic (Akron, OH)
- …outcomes. **Cleveland Clinic Akron General is looking for knowledgeable Clinical Nurse Specialist with a background in critical care nursing to support ... nurse critical care and progressive care orientation, 3. Review inpatient orders to...the applicable hospitals. **CNS** + Currently licensed as a Clinical Nurse Specialist in applicable state(s). +… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Clinical Nurse is a Registered Professional Nurse who provides safe, competent quality care based on nursing theory and research ... and family members who have concerns and escalates to Clinical Nurse Manager/Assistant Nurse Manager/Nursing.... **Professional Development** 1. Contributes to the environment of care to support clinical colleagues, patients and… more
- Actalent (Dallas, TX)
- Clinical Review Nurse (Utilization...Perform concurrent reviews to assess member's overall health. + Review the type of care being delivered ... Remote Job Description The role of the Utilization Management Nurse involves performing concurrent reviews, determining the member's overall...review and prior authorization. + Knowledge in managed care and patient care . Additional Skills &… more
- UNC Health Care (Chapel Hill, NC)
- …staff development, resource for best practice, and assist with supervision. Summary: The Clinical Nurse IV practices at the level of an expert practitioner ... demonstrating clinical leadership on the unit, the Clinical Nurse IV serves as a resource...clinical staffing and skill mix to meet patient care needs on own shift and upcoming shift. Effectively… more