experience required Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure Valid... RN license in the District of Columbia and/or the State of Maryland based on work location(s) Upon Hire required and CCM...
offer. Responsibilities Manage effective utilization review processes, including management of patient statusing processes and monitoring... programs and key performance indicators for all utilization review activities. Interact with medical, nursing, and executive...
for additional specifics. Responsibilities Manage effective utilization review processes, including management of patient... to develop and implement quality review programs and key performance indicators for all utilization review activities. Interact...
must have Utilization Review and Discharge Planning experience. Additional Information As one of the largest health care providers... ability to commute to Grace Medical Center for scheduled shifts.** Position Summary: Conducts concurrent and retrospective chart review...
Authorization and pre-certification, utilization review and denial management, Care Coordination, Collaborative treatment... of experience and 1 year of cumulative leadership experience required. Additional Preferences The RN Manager, Post Acute...
required Preferred experience in case management, discharge planning or utilization review Valid Maryland Nursing License... interdisciplinary team, the Case Manager provides leadership and advocacy in the coordination of patient-centered care across the...
About this role: As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care... your business, and advanced leadership. As a Clinical Manager, you may advance your career into an Area Team Lead or Director...
About this role: As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care... your business, and advanced leadership. As a Clinical Manager, you may advance your career into an Area Team Lead or Director...
Discharge Case Manager initiates proactive outreaches to facility CM/UM/Discharge staff upon generating the daily census... exemplary knowledge of utilization management and care coordination processes as a foundation for transition planning activities...
Authorization and pre-certification, utilization review and denial management, Care Coordination, Collaborative treatment... of experience and 1 year of cumulative leadership experience required. Additional Preferences The RN Manager, Post Acute...
, or utilization issues to appropriate MedStar personnel. Identifies inpatients requiring additional services and initiates care...'s policy. Monitors utilization of all services for fraud, waste and abuse. Performs telephonic ACD line coverage for Clinical...
preferred Case management experience preferred Utilization review skills using Interqual Criteria preferred SPECIFIC... use of available resources to promote quality, cost effective outcomes. The Case Manager, in close collaboration with the physician...
preferred Case management experience preferred Utilization review skills using Interqual Criteria preferred SPECIFIC... use of available resources to promote quality, cost effective outcomes. The Case Manager, in close collaboration with the physician...
and/or Compact State Licensure Valid RN license in the State of Maryland. Upon Hire required and CCM - Certified Case Manager... to plan of care, identification of problems, discharge planning, and payer concerns such as LOS. Collaborates with utilization...
-effective utilization of available resources (human, material and financial) and ensures a high level of quality of care... actions. Maintains ongoing communication with associates to review programs, provide feedback, discuss new developments...
regulations and mandates. 35% Organizes the appeal case for physician review by compiling clinical, contractual, medical policy... the written case for review and, following the physician review, communicates the final decision to the member...
experience in Medical Review, Utilization Management or Case Management at Client , or similar Managed Care organization... and Federal regulations and mandates. 35% Organizes the appeal case for physician review by compiling clinical, contractual...