Registered Nurse - Case Management - Appeals | San Francisco, CA Registered Nurse - Case Management - Appeals... We are seeking a dedicated and experienced Registered Nurse (RN) specializing in Case Management for Appeals at a renowned medical...
. Assists with concurrent and retrospective utilization review activities including denials and appeals. Works with physicians... with nursing, therapy and other ancillary departments to ensure proper utilization. If no Lead Case Manager, the CM...
implementation of processes related to the concurrent review of the clinical documentation in the inpatient medical record of Optum... * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Provides expert level review of inpatient...
to other groups and outside organizations as assigned. Participate in utilization review activities as assigned. Tracks medical... loan forgiveness programs - NHSC/Nurse Corps/Pediatric Specialty | HPSA Scores: Primary: 17 | Dental: 25 | Mental: 20...
, and the administrator-on-call. Additionally, this position will include basic knowledge of Utilization Review rules... duties include provision of managerial and clinical links between the nurse manager and department directors in their absence...
. Experience: A minimum of two years of clinical experience in Utilization Review or Case Management is preferred. Per Diem...: Reports to the Director of Case Management Plan, organize and deliver utilization management activities for BOP patients...
coordinators/discharge planners, utilization review coordinators and utilization review technicians. Assesses needs and plans... a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity...
coordinators/discharge planners, utilization review coordinators and utilization review technicians. Assesses needs and plans... a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity...
, utilization review and management, and discharge planning. Essential Functions Care Coordination Coordinates clinical... and effectively. Utilization Management Conducts medical necessity review for appropriate utilization of services from admission...
as analyzing, interpreting and presenting clinical quality-related data Previous case review experience Preferred... for Professionals in Patient Safety California Registered Nurse (RN) - CA Board of Registered Nursing Other Qualification...
in the identification of individuals requiring Case Management and the utilization of opportunities within the local... medical records systems and software skills. Knowledge of ICE/DHS medical case review and care preferred. Education...
. Assists in the review of new hires and their medical credentials. Personnel Management/Staffing Identifies staffing needs... nursing personnel requirements and position competencies for the nursing department. Ensures effective utilization of staff...
. Assists in the review of new hires and their medical credentials. Personnel Management/Staffing Identifies staffing needs... nursing personnel requirements and position competencies for the nursing department. Ensures effective utilization of staff...
Medical Reception Department. Responsible for supervision of Medical Surveillance Programs. Assists in the review of new... requirements and position competencies for the nursing department. Ensures effective utilization of staff and departmental...
Medical Reception Department. Responsible for supervision of Medical Surveillance Programs. Assists in the review of new... requirements and position competencies for the nursing department. Ensures effective utilization of staff and departmental...
in the identification of individuals requiring Case Management and the utilization of opportunities within the local... medical records systems and software skills. Knowledge of ICE/DHS medical case review and care preferred. Education...
Surveillance Programs Assists in the review of new hires and their medical credentials. Personnel Management/Staffing... effective utilization of staff and departmental resources. Monitors overtime requirements in accordance...
Surveillance Programs Assists in the review of new hires and their medical credentials. Personnel Management/Staffing... effective utilization of staff and departmental resources. Monitors overtime requirements in accordance...
Surveillance Programs Assists in the review of new hires and their medical credentials. Personnel Management/Staffing... effective utilization of staff and departmental resources. Monitors overtime requirements in accordance...
. Assists in the review of new hires and their medical credentials. Personnel Management/Staffing Identifies staffing needs... nursing personnel requirements and position competencies for the nursing department. Ensures effective utilization of staff...