and maintenance of high quality care through the analysis, review, and evaluation of clinical criteria as it relates to patient.... Managing and effectively utilizing insurance benefits through timely prospective, concurrent, and retrospective review...
and maintenance of high quality care through the analysis, review, and evaluation of clinical criteria as it relates to patient.... Managing and effectively utilizing insurance benefits through timely prospective, concurrent, and retrospective review...
perspective on workplace flexibility. Position Purpose: Performs a clinical review and assesses care related to mental health... state required. Master’s degree for behavioral health clinicians required. Clinical knowledge and ability to review...
), MercyOne Des Moines Join the MercyOne Family! We are looking to hire a Utilization Review RN! Responsible for the review... physician review process when appropriate. Interacts with insurance providers to obtain authorization and continued stay...
a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care... in accordance with regulatory guidelines and criteria Performs concurrent review of behavioral health (BH) inpatient to determine...
Utilization Management functions, which includes: admission, concurrent and retrospective utilization review for medical necessity... experience of 5 or more years in lieu of BSN degree. Requires minimum of five years' clinical experience as staff nurse. Prior...
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...
and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness. Qualifications... and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission...
concurrent information that includes patient status, treatment, and anticipated discharge Provide clinical information...Job Description: Responsibilities Utilization Review Director Opportunity - HRI Hospital is seeking a Director...
concurrent information that includes patient status, treatment, and anticipated discharge Provide clinical information...Job Description: Responsibilities Utilization Review Director Opportunity - HRI Hospital is seeking a Director...
Experience 5 years experience to include 2 years of clinical experience and minimum of 3 years of recent utilization review...Utilization Review RN - PRN - Monday-Friday Days Three (3) years of utilization review experience in acute care...
Registered Nurse (RN) licensure or clinical background is preferred. Certification in Utilization Review (CPUR, CPHQ, or similar...Job Summary: The Utilization Review Manager is responsible for ensuring that hospital admissions, services...
clinical reviews to support authorization obtainment, avoid payment denial, and optimize reimbursement. The Utilization Review... licensure through the enhanced Nurse Licensure Compact (eNLC). EXPERIENCE: 1. Three (3) years of healthcare clinical...
Experience 5 years experience to include 2 years of clinical experience and minimum of 3 years of recent utilization review...Utilization Review RN - PRN - Monday-Friday Days Three (3) years of utilization review experience in acute care...
JOB SUMMARY The Utilization Review (UR) Nurse is a registered nurse who provides clinical review against nationally... departments regarding medical necessity for prospective, concurrent and retrospective reviews. The UR RN provides feedback...
-certification and concurrent reviews. Accumulates, analyzes, and documents timely clinical information to insurance payers... by licensure and/or experience. What you will do: Pursues pre-authorization and concurrent review authorizations...
Job Description: The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed... Registered Nurse License 3 years Nursing Preferred Qualifications: Bachelor's Degree Nursing Or 3 years Utilization Review...
and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness. Qualifications... and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission...
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 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...