possible given their specific needs. Responsible for providing quality case management, utilization review activities... Qualifications Masters degree in Social Work.or Registered Nurse with current California license 2 years of experience...
review to determine the appropriateness of services rendered and to ensure that quality care is delivered in a cost-effective... as appropriate. For patients who are transitioning to the Skilled Nursing Facilities, refers to nurse practitioner and case manager...
possible given their specific needs. Responsible for providing quality case management, utilization review activities... Qualifications Masters degree in Social Work.or Registered Nurse with current California license 2 years of experience...
of functions of case management, utilization review and management, and discharge planning. Essential Functions Care... rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified...
of functions of case management, utilization review and management, and discharge planning. Essential Functions Care... rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified...
years of clinical experience and/or utilization review experience. Current active, valid and unrestricted RN license... providers. Focuses on relatively complex case types that do not require the training or skill of a registered nurse. Acts...
is distinguished from the Utilization Review Coordinator in that the latter has responsibility for utilization of records within the... quality management system including utilization review, medication monitoring, confidentiality of records and peer review...
" as needed. Participates in discharge planning with patients, physicians, social workers, patient education, utilization review... Licenses/Certifications: Registered Nurse (RN) licensure in the state of practice: Required Cardiopulmonary Resuscitation...
of processes related to the concurrent review of the clinical documentation in the inpatient medical record of Optum 360 clients..., with automated review of 100% of records Improved tracking, transparency and reporting related to CDI impact, revenue capture...
to our clients and members, providing oversight to the quality management, utilization management and credentialing functions of the... organization Primary Responsibilities: Develop, implement, and update medical management programs (utilization management...
of processes related to the concurrent review of the clinical documentation in the inpatient medical record of Optum 360 clients..., with automated review of 100% of records Improved tracking, transparency and reporting related to CDI impact, revenue capture...
to our clients and members, providing oversight to the quality management, utilization management and credentialing functions of the... organization Primary Responsibilities: Develop, implement, and update medical management programs (utilization management...
of functions of case management, utilization review and management, and discharge planning. Essential Functions Care... rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified...
of functions of case management, utilization review and management, and discharge planning. Essential Functions Care... rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified...
Case Management strategy. Qualifications: Registered Nurse required Director of Case Management experience..., including Utilization Management Supports medical necessity and denial prevention, transition management promoting appropriate...
cost while ensuring the highest quality of care is maintained. Applies review criteria to determine medical necessity... the delivery of cost-effective quality health-care and assists in the identification of appropriate utilization...
to utilization review and discharge planning The tradition of caring that culminated in the establishment of Corona Regional... or University preferred in related field. Five (5) to Seven (7) years of clinical experience in Case Management/Utilization Review...
Certified Clinical Coder Nurse, Senior will report to the Senior Manager, Facility Compliance Review. In this role...Job Description: Your Role The Facility Compliance Review team reviews post service prepayment facility claims...
to utilization review and discharge planning The tradition of caring that culminated in the establishment of Corona Regional... or University preferred in related field. Five (5) to Seven (7) years of clinical experience in Case Management/Utilization Review...
utilization. Assures appropriate staff support of Utilization Management and other relevant committees. Supports the... training based on data analysis and review. Responsible for the Policies, Procedures, Budget and Program Documentation...