in the life of a Utilization Review RN/Integrated Care Manager with Sentara Health. As a Utilization Review Nurse.... keywords: LinkedIn, Nursing Acute Care, Full Time, Case Management, RN, Registered Nurse, BSN, ASN, utilization review, patient...
authorization of designated healthcare services clinical review determinations for Medicare Line of Business. The Manager... RN License Requires at least 7 years of prior relevant experience including 3 years of management experience...
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...
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...
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...
*** ***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...
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...
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...
by licensure and/or experience. What you will do: Pursues pre-authorization and concurrent review authorizations..., taking into consideration the current episode of care as well as prior treatment and anticipated future clinical care...
Grade: N03 Salary based on years of nursing licensure Summary: The Clinical Research Nurse, under the direction... will work independently to drive day to day research activities from study start-up to closeout. The Clinical Research Nurse...
: Licensed Registered Professional Nurse (RN) - Indiana (IN) within 1 year - Indiana Professional Licensing Agency (IPLA...); Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR), Education...
: Licensed Registered Professional Nurse (RN) - Indiana (IN) within 1 year - Indiana Professional Licensing Agency (IPLA...); Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR), Education...
Nurse (RN) on the Community Partner team provides clinical care management and intensive care coordination for people..., Clinical Care Management, ACO, Medicaid, Care Team, Community Partners, Care Manager, VinfenIC, VinfenRN, RN, Registered Nurse...
Job Description The Clinical Nurse Navigator uses their oncology-specific clinical knowledge to offer individualized..., a Clinical Nurse Navigator provides education and resources to facilitate informed decision making and timely access to quality...
Job Description The Clinical Nurse Navigator uses their oncology-specific clinical knowledge to offer individualized..., a Clinical Nurse Navigator provides education and resources to facilitate informed decision making and timely access to quality...
Job Description The Clinical Nurse Navigator uses their oncology-specific clinical knowledge to offer individualized..., a Clinical Nurse Navigator provides education and resources to facilitate informed decision making and timely access to quality...
Nurse (RN) on the Community Partner team provides clinical care management and intensive care coordination for people..., Clinical Care Management, ACO, Medicaid, Care Team, Community Partners, Care Manager, VinfenIC, VinfenRN, RN, Registered Nurse...
and has what they need for success. Qualifications: Certifications: Licensed Registered Professional Nurse (RN) - Illinois Department... with patient/family and physician to determine next level of care Conducts case review presentations to educate peers on unique...
for: a) Recovering revenue associated with disputed/denied clinical claims or those eligible for clinical review b) Preparing... potential of clinical disputes/denials or those eligible for clinical review. Demonstrates proficiency in use of medical...
Job Responsibilities-Heart Failure Clinic Nurse Responsible for review and maintenance of referral work queue Triaging patient calls... and medication questions.failure. Assists in prior authorization process for medications and non-invasive procedures (echo, stress...