appropriate level for understanding Review the entire medical record for accuracy, and appropriate clinical treatment... experience and understanding of disease pathology to review chart/clinical information, ask appropriate questions, and identify...
. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the... meaning behind Caring. Connecting. Growing together. The Director of Contracted Clinical Support for DNG services...
U.S. as you take on some tough challenges. Primary Responsibilities: Perform initial and concurrent review of inpatient cases applying evidenced... that is seriously shaping the way health care services are delivered. As an Inpatient Care Management Nurse, you will be responsible...
. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the... meaning behind Caring. Connecting. Growing together. The Director of Contracted Clinical Support for DNG services...
appropriate level for understanding Review the entire medical record for accuracy, and appropriate clinical treatment... experience and understanding of disease pathology to review chart/clinical information, ask appropriate questions, and identify...
, including response to payor requests for concurrent and retrospective review information including Medicare and MediCal... patients; develops plans of care and discharge plans, monitors all clinical activities, makes recommendations for alternative...
, admissions, observation and concurrent review according to standard policies and procedure. Utilization Management reviews... to use your skills and expertise. Looking for nursing career opportunities? Please visit Registered Nurse (RN) - Discharge Planner...
for an assigned case load. Concurrent and retrospective clinical review of inpatient medical records to evaluate the utilization... regarding the MOON and/or IMM timely to the care coordinator and/or utilization review nurse. Support and assist with clerical...
Description Summary: The Utilization Management Nurse II is responsible for determining the clinical... and guidelines related to UM. This Nurse effectively communicates with internal and external clinical professionals, efficiently...
a leadership role with the interdisciplinary team to achieve optimal quality, clinical and resource outcomes. Works to provide... a comprehensive range of services or clinical care associated with and in accordance with standards of excellence established...
, i.e. IS/SI. Collects data related to clinical improvement initiatives for the purpose of developing action plans. Conducts concurrent...Overview Case Manager is responsible for chart review to evaluate medical necessity for admission, continued stay...
Description Summary: The Utilization Management Nurse II is responsible for determining the clinical... and guidelines related to UM. This Nurse effectively communicates with internal and external clinical professionals, efficiently...
educational programs for hospital and medical staff. Must have knowledge of general medical/nursing theory and clinical practice..., both verbally and in writing. Licenses and Certifications Licensed as a Registered Nurse with the BNE for the State of Texas...
information about this position. Coordinates utilization review activities for the purpose of monitoring standards of patient...: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Licensure in the state of WV to practice as a Registered Nurse. 2. Obtain...
is looking for a qualified Registered Nurse - Utilization Management City: Aurora State: CO Start Date 2025-03-01 End Date: 2027-11-30... applicable Minimum Requirements Registered Nurse (RN) Utilization Management: Degree/Education: Bachelors degree in nursing...
is looking for a qualified Registered Nurse - Utilization Management City: Aurora State: CO Start Date 2025-03-01 End Date: 2027-11-30... applicable Minimum Requirements Registered Nurse (RN) Utilization Management: Degree/Education: Bachelorâs degree...
as a leader of positive change. The Registered Nurse Care Manager is a member of the healthcare team and is responsible... for coordinating, communicating and facilitating the clinical progression of the patient's treatment and discharge plan .He/She...
in the clinical documentation and queries the provider using a concurrent query process following ACDIS/AHIMA Guidelines..., and acuity with an eye towards accurate medical coding). Collaborates with team members as part of the clinical review process...
concurrent review, discharge planning and care coordination; identifies alternate treatment programs; consults with physicians... in a clinical care advisory role, the Primary Nurse Coordinator assesses members for wellness education and disease management...
to include providing clinical updates to payers and/or external review organizations, collecting data, coordinating denial... interventions and utilization review activity per department and medical center standards in a timely manner. Performs and documents...