delivered Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical... providers to approve medical determinations or provide recommendations based on requested services and concurrent review...
Title - Clinical Review Nurse - Concurrent Review Duration - 6 months Shift - Tuesday to Saturday, 8am-5pm CST... | This is a strict schedule- no flexibility. Location - Remote TX Responsibilities The nurse will be reviewing about 20 cases a day...
months, contract to hire Description: Job Profile Summary: This is a fast-paced role. The nurse will be reviewing clinical.... Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being...
concurrent and secondary case reviews and advisory services to hospital partners nationwide. Our unique approach includes... Christmas Day About the role: The Clinical Support Manager is responsible for creating, driving and supporting new workflow...
department in general and the hospital. Review and analyze concurrent and retrospective clinical denials and follow the... team, and The Power of Every One. Job Title Concurrent Denial Nurse BU Location Cleveland Facility Remote Location...
nurse will be responsible for utilization review services within the scope of licensure. Conducts primary function of prior... authorization for inpatient and outpatient reviews both initial and concurrent continued stay review. Reviews for appropriateness...
Physician Advisor role will support the Utilization Review RN for second level clinical reviews for cases that do not meet...Facility: Dayton Children's - Main Campus Department: Utilization Review Team Schedule: Part time Hours: 8...
with Medicaid/MassHealth knowledge. Principal Duties and Responsibilities: Expertise in clinical review for prospective... means to be part of Mass General Brigham. Job Summary The UMCM will utilize clinical knowledge to analyze, assess...
Sentara Health is currently hiring for a Utilization Review Nurse- Remote in VA! Status: Full-time, permanent... authorization, inpatient review, concurrent review, retrospective review, medical director referrals and execution of member...
as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse is responsible for ensuring the receipt... of emergent hospital admissions, completes inpatient concurrent review, establishes discharge plans, coordinates transitions...
Our Client, a Health Insurance company, is looking for a Registered Nurse-Review Analyst for their Detroit, MI/Hybrid... location. Responsibilities: Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory...
RN- Utilization Review Nurse Inpatient *Full Time - 100% Remote Opportunity* Must reside within the New York Tri... is looking for a self-motivated and passionate RN as Utilization Review Nurse for a Full-Time position. This is an exciting and dynamic...
balance, continuous learning, and career development. Summary We are seeking a skilled Utilization Review Nurse to conduct... prior authorization, prospective, concurrent, and retrospective reviews for medical necessity and appropriateness...
RN- Utilization Review Nurse Inpatient *Full Time - 100% Remote Opportunity* Must reside within the New York Tri... is looking for a self-motivated and passionate RN as Utilization Review Nurse for a Full-Time position. This is an exciting and dynamic...
of concurrent review process for individual cases. 2. Coordinates clinical documentation to third-party payers and state agencies... to secure timely payment for patient charges. 3. Participates in the utilization review and/or quality assurance programs. 4...
balance, continuous learning, and career development. Summary We are seeking a skilled Utilization Review Nurse to conduct... prior authorization, prospective, concurrent, and retrospective reviews for medical necessity and appropriateness...
The purpose of this position is to conduct initial, concurrent, retrospective chart review for clinical, financial... communication and negotiation skills. Strong critical thinking skills and the ability to perform clinical chart review abstract...
's Best Hospitals. Summary of Essential Duties: The Utilization Management (UM) Registered Nurse - Medicare Short Stay & Concurrent... of concurrent payer denials. * This role ensures timely, accurate, and compliant clinical validation in accordance with CMS...
foundational nursing clinical skills Utilization Review nurse collaborates with the interdisciplinary team to maintain appropriate...: 8 am- 4 pm Summary: The Registered Nurse (RN), Utilization Review, as an active member of the Middle Revenue Cycle...
-effective patient outcomes. Responsible for analyzing clinical information and performing timely initial and concurrent reviews... guidelines. Possesses proficiency in utilization review systems, clinical support systems, and business support applications...