goals and objectives aligned with the overall strategic plans for Case Management and Utilization Review. Oversee Group... Hospital Case Management and Utilization Review operations, ensuring cost-effective and clinically sound care delivery...
on any regulation changes and disseminating this information appropriately. Participate in QA, Utilization Review and Patient Care... years nurse management experience preferred. Language Skills Ability to read, analyze, and interpret general business...
regulations, laws, utilization review, and management. Knowledge of medical staff by laws, rules and regulations, and the State... of utilization reviews required by the Department of State. Supervises the checking of the charts for deficiencies. Reports...
, surgical services, nursing, finance, physicians, utilization review, and medical records to ensure appropriate bed placement... for California Applicants: Responsibilities: The Licensed Vocational Nurse acts as a principal liaison between emergency services...
services, nursing, finance, physicians, utilization review, and medical records to ensure appropriate bed placement is assigned...Responsibilities The Licensed Vocational Nurse acts as a principal liaison between emergency services, surgical...
of an appropriate and effective person-centered care plan, member education and care management. Conducts initial and concurrent review... with Care Management flows. Knowledge of utilization management procedures, mental health and substance abuse community...
. Conducts initial and concurrent review for prior authorization of higher levels of care against medical necessity criteria.... Knowledge of utilization management procedures, mental health and substance abuse community resources and providers. Knowledge...
. Conducts initial and concurrent review for prior authorization of higher levels of care against medical necessity criteria.... Knowledge of utilization management procedures, mental health and substance abuse community resources and providers. Knowledge...
Nurse required Bachelor's Degree in Nursing required Director of Case Management experience in an Acute Hospital....com/Careers. Feel free to share these contact details with anyone who might be interested in Case Management and Utilization...
and the patient’s quality of life. Qualifications: Registered Nurse required Bachelor’s degree in nursing... and projects related to patient centered care and clinical resource utilization as needed Advises Senior Management on issues...
services in areas of evaluation, crisis intervention, group therapy, case management or utilization review. Leads the team... in a psychiatric setting: Preferred Licenses/Certifications: Registered Nurse (RN) or Marriage and Family Therapist (MFT...
based on own the review of clinical documentation in addition to feedback and recommendations by Utilization Review staff... for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance review and outcomes...
opportunities in resource management and utilization by oversight and review of clinical operations including but not limited...-required audits are completed. Collaborates with Medical Records Claims Review Team for external audits and records requests...
management, utilization review, care coordination experience California Registered Nurse (RN) - CA Board of Registered Nursing... ability to combine clinical/quality considerations with regulatory/financial/utilization review demands to assure patients are receiving...
initial and concurrent utilization review to ensure certification/approval of in-patient and post discharge services. 5.... Per the direction of the Care Management social worker and/or nurse, facilitates, identifies and documents all referrals made...
planning, utilization review, and/or providing psychosocial support. May review clinician assessments and patients' financial... of clinical experience in an acute healthcare system environment. One year of Utilization Review experience required. Care...
initial and concurrent utilization review to ensure certification/approval of in-patient and post discharge services. 5.... Per the direction of the Care Management social worker and/or nurse, facilitates, identifies and documents all referrals made...
initial and concurrent utilization review to ensure certification/approval of in-patient and post discharge services. 5.... Per the direction of the Care Management social worker and/or nurse, facilitates, identifies and documents all referrals made...
), focusing on utilization review and coordinating discharges. Apply now to fill a critical gap in our NOC shift coverage and make...Registered Nurse - Case Management Night Shift in South San Francisco, CA Registered Nurse - Case Management Night...
to the infirmary, transfer to emergency room, and utilization review process for specialty consultant referrals Supervise... to work either 4–10-hour days or 5–8-hour days. You will have your dedicated nurse when you see your patients...