. Comprehensive knowledge of Utilization Review, levels of care, and observation status. Working knowledge of laws, regulations... Overview: Coordinates the utilization management, resource management, discharge planning, post-acute care referrals and care...
and assumes responsibilities described in the agency corporate compliance plan. Implement all utilization review activities..., community, and industry trends. Over sees the Performance Improvement program. Participate in the review, analysis...
's Utilization Management Plan. Temporary/Relief Physician Assistants and Nurse Practitioners shall complete and return all forms... moment we are in URGENT need of a Nurse Practitioner to take on a Full-Time assignment at the correctional facility located...
, Peripheral Nerve Stimulation, etc.) Familiarity with Appropriate Utilization Review Guidelines for Pain Treatments...We are a Premier Pain Management and PM&R practice seeking a CA licensed Physician Assistant or Nurse Practitioner...
with other departments, i.e.: Pre-Admissions, Admissions, Patient Accounts, Utilization Review, PPS Coordinator, etc., to assure positive... City / Los Angeles, CA Case Manager (CM) - Full Time (on-site) Registered Nurse (RN) or Licensed Clinical Social Worker...
Active, unrestricted Registered Nurse license through the State of California 3+ years of care management, utilization... all functions of a UM nurse reviewer Compose denial letter in a manner consistent with federal regulations, state regulations...
Active, unrestricted Registered Nurse license through the State of California 3+ years of care management, utilization... all functions of a UM nurse reviewer Compose denial letter in a manner consistent with federal regulations, state regulations...
and working in cooperation with other departments, such as Utilization Management, the Long-Term Care (LTC)) Nurse Specialist RN... utilization available to Members. The LTC Nurse Specialist will possess knowledge of current upcoming programs and services...
a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education and experience...Anticipated End Date: 2025-04-04 Position Title: Med Mgmt Nurse CA (US) Job Description: The Med Mgmt Nurse CA...
American Heart Association (AHA) Controlled Substances Utilization Review and Evaluation System (CURES) registration... team working within the scope of practice of a Nurse Practitioner (NP). The NP will serve as clinical area expert...
to all populations across the ACA Marketplace, Medicare, and Medicaid. The Utilization Management (UM) Prior Authorization (PA) Nurse..., and evidence-based medical necessity criteria. The UMPA Nurse also collects and analyzes utilization data and monitors the quality...
listed are necessarily performed by each individual in the classification. 1. Coordinates all utilization review functions.... Within the last 3 years, experience in Case Management in an acute setting or utilization review at a medical group or health...
each audit area. ▪ Keeps abreast of company policies and procedures, current developments in managed care, utilization review... in researching utilization review and case management best practice concepts in order to apply as appropriate. Great listening...
in clinical education, inservice and nursing staff meetings. Participate in Quality Management and Utilization Review Activities... Job Description: The Inpatient Registered Nurse provides hospice care and is skilled at assessing pain and other complex symptoms at the...
policies and procedures for infirmary admissions, emergency room transfers, and the utilization review process for specialty... of care support. How you make a difference The Nurse Practitioner provides a full range of medical services for inmates...
for all nursing and other designated patient care functions/services within the hospital organization. The Chief Nurse Executive..., at the medical executive committee and medical staff committees. The Chief Nurse Executive has oversight for the professional...
Anticipated End Date: Position Title: Nurse Reviewer I Job Description: Location: This is a Virtual role... benefits. Works on reviews that are routine having limited or no previous medical review experience requiring guidance...
Participate in peer review, quality assurance, and staff meetings with other health practitioners as required Ensure... Collaborate with the regional management in participating in a community event to promote TLC to generate increased utilization...
health RN to review current 1:1 sitter use and evaluate options to reduce sitter utilization by 1) discontinuation of sitter... our community with the highest quality healthcare! Position Summary: As a Charge Nurse, you will provide care to an assigned...
health RN to review current 1:1 sitter use and evaluate options to reduce sitter utilization by 1) discontinuation of sitter... our community with the highest quality healthcare! Position Summary: As a Charge Nurse, you will provide care to an assigned...