documentation Conduct prior authorization and concurrent reviews in accordance with clinical guidelines and organizational policy...Utilization Review Nurse – LTSS (Contract-to-Perm) Location: Remote however Candidates must reside in one of the...
in the life of a Utilization Review RN/Integrated Care Manager with Sentara Health. As a Utilization Review Nurse... specializing in Utilization review, the registered nurse will be responsible for utilization review services within the scope...
of inpatient clinical experience. 1+ year in prior authorization reviews using InterQual. Strong written communication skills... balance, continuous learning, and career development. Summary We are seeking a skilled Utilization Review Nurse to conduct...
of inpatient clinical experience. 1+ year in prior authorization reviews using InterQual. Strong written communication skills... balance, continuous learning, and career development. Summary We are seeking a skilled Utilization Review Nurse to conduct...
authorization of designated healthcare services clinical review determinations for Medicare Line of Business. The Manager...Job Description: Your Role The Utilization Management Concurrent Review team ensures accurate and timely...
. Responsibilities: Review and authorize, as appropriate, phone/fax referral/authorization and clinical form requests per established... requests not clearly meeting established criteria Assist the Prior Authorization non-clinical reps with the Prior...
or ambulatory setting. One (1) + years of pediatric nursing experience and prior experience as Utilization Review nurse...+ shifts per week. The Utilization Review Representative (LVN) is responsible for utilization review of all inpatient...
, analysis, and shares best practices for presentation and education during Case Review Meetings. Authorization... donation discussion and authorization process for potential organ and tissue donor families prior to, during, and after death...
Experience 5 years experience to include 2 years of clinical experience and minimum of 3 years of recent utilization review... experience. and Prior experience with Epic CCM. Licenses and Certifications (RN) REGISTERED NURSE Holds an active...
to behavioral health (BH) and/or autism spectrum disorder needs and clinical standards Performs prior authorization reviews related.... Behavioral health clinical knowledge and ability to review and/or assess ABA Treatment Plans required. Knowledge of ABA services...
*** ***CANDIDATE WILL WORK UP TO 4 HOLIDAYS A YEAR WITH THIS ROLE*** Position Purpose: Performs a clinical review and assesses care..., during, and after services to ensure level of care and services are medically appropriate Performs prior authorization reviews related...
a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care... Performs prior authorization reviews related to mental health and substance abuse to determine medical appropriateness...
perspective on workplace flexibility. Position Purpose: Performs a clinical review and assesses care related to mental health... to ensure level of care and services are medically appropriate Performs prior authorization reviews related to mental health...
Experience 5 years experience to include 2 years of clinical experience and minimum of 3 years of recent utilization review... experience. and Prior experience with Epic CCM. Licenses and Certifications (RN) REGISTERED NURSE Holds an active...
Maintain 100% accuracy of clinical review case notes in Facets Maintain productivity standards and maintain compliance... Medical Director to review using appropriate protocols-based members clinical and benefit information Maintain compliance...
Associate position facilitates the prior authorization of managed care patients. The utilization review component of the...: Utilization Review: Obtain prior authorization and timely insurance notification. Communicate Provider plans to notify insurance...
as a leader of positive change. The Clinical Research Nurse is responsible for coordinating and overseeing clinical research... Patient Care in clinical research trials. The Clinical Research Nurse carries out the research and works under the general...
applicable. Intake & Documentation Review all new intake paperwork for completeness and accuracy Input clinical data...Job Summary: The LPN Clinical Coordinator plays a pivotal role in supporting clinical leadership team at Guardian Home...
Institute for Medical Research at the Durham VA Health Care System Clinical Research Nurse - Greenville PI: Dr...), is looking for a Prospective Clinical Research Nurse to oversee select clinical research studies conducted by the Principal Investigator, Dr...
Institute for Medical Research at the Durham VA Health Care System Clinical Research Nurse - Greenville PI: Dr...), is looking for a Prospective Clinical Research Nurse to oversee select clinical research studies conducted by the Principal Investigator, Dr...