a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education and experience...Anticipated End Date: 2025-02-28 Position Title: Med Mgmt Nurse CA (US) Job Description: The Med Mgmt Nurse CA...
Overview: Are you a highly motivated Psychiatric Nurse Practitioner looking for a rewarding and meaningful... documentation for clinical records and billing. Performs other duties as assigned by supervisor. Participates in Utilization...
Overview: Are you a highly motivated Psychiatric Nurse Practitioner looking for a rewarding and meaningful... documentation for clinical records and billing. Performs other duties as assigned by supervisor. Participates in Utilization...
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...
to his/her care. Participates in peer review and performance improvement as assigned. Participates in utilization review of medical...One Health seeks a Part Time, Full Time or Per-Diem Registered Nurse to join its dynamic team of healthcare...
to his/her care. Participates in peer review and performance improvement as assigned. Participates in utilization review of medical...One Health seeks a Part Time, Full Time or Per-Diem Registered Nurse to join its dynamic team of healthcare...
to his/her care. Participates in peer review and performance improvement as assigned. Participates in utilization review of medical...One Health seeks a Part Time, Full Time or Per-Diem Registered Nurse to join its dynamic team of healthcare...
Reporting to the Senior Manager, Concurrent Review & Long Term Care, the Long-Term Care Nurse Manager oversees daily... in utilization review, resource management. Two to five years' experience in an acute care or post-acute setting. Two to three...
utilization of services; ensuring continued skilled need; monitoring of homebound status; review of documentation in the medical... - 57/hr PLUS a $5,000 sign on BONUS! Job Description: VNA Health is looking for compassionate Registered Nurse Case...
with all data collections and auditing activities. Accountable for completion of the Annual Standing Order Review and Internal... Classification of Disease (ICD) coding. Manages clinic financials including efficient utilization of supplies or equipment...
. This position requires collaboration with Physicians, Utilization Managers, Medical Social Workers, and bedside RNs to ensure the... resource coordination. The primary goals are to achieve optimal health, access to care, and appropriate utilization...
the acute care patient experience. This role collaborates with Physicians, Utilization Managers, Medical Social Workers... continuum. Key Responsibilities Patient Initial and Continued Assessment Review initial physician admission care plan...
concurrent review and prior authorization department processes and workflows Develop and design training modules for Utilization... improvements for Utilization Management (Concurrent Review and Prior Authorizations) Qualifications: Your Knowledge...
coordination of care with specialists, community resources. Care Managers perform a blended function of utilization management... member care review with medical groups or individual providers for continuity of care, out of area/out of network...
coordination of care with specialists, community resources. Care Managers perform a blended function of utilization management... member care review with medical groups or individual providers for continuity of care, out of area/out of network...
Overview: The incumbent utilizes clinical judgement in providing utilization management services. The focus... services. Responsibilities: Conducts retrospective claims review, either in the aggregate or on an individual basis. Provides...
including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization...) and Appeals and Grievance department (AGD). Conducts member care review with medical groups or individual providers...
of the utilization of services, and preparation of appropriate reports. Work closely with the Director of Case Management..., resource utilization, past and present treatment plan and services, prognosis, short and long-term goals, treatment...
, the Case Manager performs clinical review of medical specialty pharmacy services, coordinates transition of care, product... assessment activities Utilization of health prevention guidelines and general health and wellness strategies to achieve goals...
, the Case Manager performs clinical review of medical specialty pharmacy services, coordinates transition of care, product... assessment activities Utilization of health prevention guidelines and general health and wellness strategies to achieve goals...