a Full-Time Lead Utilization Review Nurse (RN) who will be responsible for partnering with the Director of Utilization... Management to oversee the daily operations of the department. This includes monitoring the activities of clinical and support...
Engagement Description Perform prospective, concurrent, and retrospective review of inpatient, outpatient, ambulatory... as: Registered Nurse-Review Analyst:...
Summary Position Summary: Conducts concurrent and retrospective chart review for clinical, financial and resource... Functions: Chart Review Reviews the medical record by applying utilization review criteria, to assess clinical, financial...
Job Description... Perform prospective, concurrent and retrospective review of post-acute care services to ensure... member outreach assessments. Rewuirements: Above average computer skills (Microsoft office). Clinical experience in SNF...
Precertification with payors. Concurrent Clinical review with payors. Document in the electronic system daily in real time...: Neuropsychiatric Hospitals is looking for a Utilization Review Nurse (RN) to coordinate patients’ services across the continuum of care...
to the next appropriate level of care; Conducts admission and concurrent review using current evidence-based clinical... of medical terminology related to patient charts; good knowledge of Patient Review Instrument (PRI); good knowledge of clinical...
concurrent review, post-acute review, discharge planning, medical and behavioral care management and prevention to improve... and with support from some specialized clinical teams. Serves as a resource to others. This new cross-functional collaboration...
concurrent review, post-acute review, discharge planning, medical and behavioral care management and prevention to improve... and with support from some specialized clinical teams. Serves as a resource to others. This new cross-functional collaboration...
, clinical research, medical education, a foundation, an accountable care organization, community services... of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist...
medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical... institution Required Experience 3 years as a Registered Nurse in an acute care setting Required 1 year experience in UR...
admitted to acute level of care. Conducts daily concurrent clinical reviews for utilization/quality management activities...Requisition ID 39856 Department Clinical Resource Management Location Escondido, California Union CNA...
authorization and concurrent review) as a Registered Nurse within a managed care organization desired. Experience... performance with regard to prior authorization, medical necessity determinations, concurrent review, retrospective review...
Details Department: Utilization Review Schedule: Full-time, 8-hour day shift, Monday-Friday, weekends and holidays... Review RN, you will provide health care services regarding admissions, case management, discharge planning and utilization...
for review and determination. Gathers clinical information to conduct continued stay utilization review activities with payers... on a daily basis. Performs concurrent and retrospective clinical reviews with various payers, utilizing the appropriate...
for review and determination. Gathers clinical information to conduct continued stay utilization review activities with payers... on a daily basis. Performs concurrent and retrospective clinical reviews with various payers, utilizing the appropriate...
Job Description: The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed... and interprets the implications of clinical status and the medical treatment plan with current federal regulations/guidelines thereby...
. Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors... to determine medical appropriateness in accordance with regulatory guidelines and criteria Performs concurrent review...
clinical reviews to support authorization obtainment, avoid payment denial, and optimize reimbursement. The Utilization Review... OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). EXPERIENCE: 1. Three years clinical...
LifeMart Responsibilities: Filing documents as needed. Initial Precertification with payors. Concurrent Clinical review...: Doctors NeuroPsychiatric Hospitals is looking for a PRN Utilization Review Coordinator to coordinate patients’ services...
criteria. The Care Review Clinician will create authorizations, manage clinical reviews, and collaborate with medical directors... to determine if requests meet COC criteria or Community Support criteria. Provide concurrent review and prior authorizations...