. Conducts initial and concurrent review for prior authorization of higher levels of care against medical necessity criteria..., and Whole Health markets. Possesses clinical knowledge, understands best practices and continuous learning skills, reviews...
concurrent review of members admitted to inpatient facilities, residential treatment centers, and partial hospitalization... programs. Maintain contact with the inpatient facility utilization review personnel to assure appropriateness of continued...
. Concurrent review of patients clinical information for efficiency and correct level of care and admission status. Interface... to deliver world-class care. Here, you'll work alongside some of the best clinical talent in the nation leading the way...
We are looking for a Clinical Director to lead all aspects of utilization management (UM) within our Healthcare... for pre-service, concurrent, and post-service medical necessity reviews. You will also provide leadership and oversight of the...
great businesses with a shared vision of using technology innovation, clinical services and network solutions to help... a qualified Utilization Reviewer who can work remotely from home. The ideal candidate performs utilization review on workers...
: Responsible for the review of clinical documentation in the Electronic Medical Record (EMR), comparing it to the nationally... accepted and evidence-based criteria to certify an admission to the facility, and for concurrent/continued stay review...
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...
effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the... seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost...
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...
effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the... seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost...
effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the... seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost...
as defined by the Nebraska Nurse Practice Act. Minimum of two (2) years recent clinical experience required. Prior care... review activities, including concurrent and retrospective reviews as required. Determines the medical necessity of request...
effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the... seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost...
for the purpose of completing initial and concurrent utilization review to ensure certification/approval of in-patient... and the ability to manage multiple tasks effectively, supporting both clinical and administrative functions within the...
. Here, you'll work alongside some of the best clinical talent in the nation leading the way in medical innovation and breakthrough... Director of Case Management, the Nurse Case Manager will assess all patients within their defined geographical scope of service...
Job Description: Responsibilities We are currently looking for a qualified Utilization Review Coordinator... UR Coordinator conducts initial and concurrent reviews with insurance companies. The Vines Hospital, located in Ocala...
Job Description: Responsibilities We are currently looking for a qualified Utilization Review Coordinator... UR Coordinator conducts initial and concurrent reviews with insurance companies. The Vines Hospital, located in Ocala...
Performs review of anticipated admissions utilizing InterQual criteria to assess for appropriate level of care assignment... on initial assessment and concurrent collaboration with other care givers, external service organizations, agencies...
UM activities as required based on local structure to include providing clinical updates to payers and/or external review... and transitions. Documents discharge planning interventions and utilization review activity per department and medical center...
clinical updates to payers and/or external review organizations, collecting data, coordinating denial activity, supporting... to assure timely progression of care and transitions. Documents discharge planning interventions and utilization review activity...