* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Perform initial and concurrent review... that is seriously shaping the way health care services are delivered. As an Inpatient Care Management Nurse, you will be responsible...
. Performs admission and concurrent utilization review in compliance with review requirements for Managed Care contracts... (BSN) o Associate of Science in Nursing (ASN) o Be a Diploma Nurse with 5 or more years of applicable/related experience...
: Current North Carolina State Registered Nurse License, if applicable Current North Carolina Driver’s License Current CPR... appropriate and timely reporting of occurrences by maintaining a Healthcare Peer Review Reporting system (Occurrence...
and concurrent utilization review in compliance with review requirements for Managed Care contracts, governmental payors... (i.e. Medicare, Medicaid, and Champus) and departmental review policies; adheres to Utilization Management Plan. Communicates...
: Current North Carolina State Registered Nurse License, if applicable Current North Carolina Driver’s License Current CPR... appropriate and timely reporting of occurrences by maintaining a Healthcare Peer Review Reporting system (Occurrence...
areas. This position requires the ability to combine clinical/quality considerations with regulatory/financial/utilization... review demands to assure patients are receiving care in the appropriate setting and level of care. The position creates...
in order to avoid unnecessary delays in discharge. Documents all Avoidable Days in CANOPY system. Performs clinical review... Manager (CM) coordinates the clinical and financial plan for patients. Performs overall utilization management, resource...
policies and clinical guidelines within scope of licensure. These reviews may require in-depth review; however, any deviation... years of clinical experience and/or utilization review experience. Current active, valid and unrestricted RN license...
Improvement and Patient Safety meetings. Completes Performance Improvement activities through concurrent review of patient care... College of Surgeons Trauma Outcomes Performance Improvement Course (TOPIC). Experience: Two to three years of clinical...
of care review activities coordination with the interdisciplinary team and any outside third party payers communicating... admission review within 24 hours of admission on all patients in case load utilizing InterQual Criteria to determine if patient...
weight objects. Concurrent Clinical Management Coordinates care with the multi-disciplinary team to facilitate... and integration of quality measures/evidence into clinical practice. Utilization Review: Performs an initial comprehensive...
RN Utilization Case Manager Full Time Day POSITION SUMMARY: Performs concurrent utilization review activities...: Registered Nurse, Licensed in State of New Jersey, Current acute care clinical knowledge with broad-base medical / surgical...
of hire. Upon hire: Alaska Registered Nurse License. 2 years Clinical nursing experience. Preferred Qualifications...: Bachelor's Degree 3 years Clinical nursing experience. 1 year Utilization Management-review experience, AND Discharge...
on local structure to include providing clinical updates to payers and/or external review organizations, collecting data... planning interventions and utilization review activity per department and medical center standards in a timely manner. Performs...
and concurrent utilization review in compliance with review requirements for Managed Care contracts, governmental payors... (i.e. Medicare, Medicaid, and Champus) and departmental review policies; adheres to Utilization Management Plan. Communicates...
on local structure to include providing clinical updates to payers and/or external review organizations, collecting data... planning interventions and utilization review activity per department and medical center standards in a timely manner. Performs...
RN Utilization Case Manager Part Time Day POSITION SUMMARY: Performs concurrent utilization review activities...: Registered Nurse, Licensed in State of New Jersey, Current acute care clinical knowledge with broad-base medical / surgical...
, observation and concurrent review according to standard policies and procedure. Utilization Management reviews and analyze... Las Cruces, New Mexico Req ID 7416-13569 Post Date Jan. 22, 2025 CategoryProfessional - Clinical FacilityMemorial Medical...
for patient’s health care needs. Performs admission and concurrent utilization review in compliance with review requirements... for Managed Care contracts, governmental payors (i.e. Medicare, Medicaid, and Champus) and departmental review policies; adheres...
for patient’s health care needs. Performs admission and concurrent utilization review in compliance with review requirements... for Managed Care contracts, governmental payors (i.e. Medicare, Medicaid, and Champus) and departmental review policies; adheres...