experience in nursing in an acute care setting through direct patient care, utilization review, case management or quality review... years experience in a JA Thomas Clinical Documentation Improvement program. Current RN license in Georgia. Minimum 4 years...
disorder facility-based and outpatient professional treatment health benefits through telephonic or written review. Primary..., such as RN LCSW LMSW LMHC LPC LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health...
of working as a CDI/Coding auditor is preferred Prior experience of working in inpatient case management or utilization review... that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity...
disorder facility-based and outpatient professional treatment health benefits through telephonic or written review. Primary..., such as RN LCSW LMSW LMHC LPC LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health...
auditor is preferred Preferred and Prior experience of working in inpatient case management or utilization review is preferred... within 180 Days Reg Nurse (Single State)-Preferred or RN - Multi-state Compact-Preferred or Cert Coding Spec-Preferred or Cert...
. Assists with development of utilization/care management policies and procedures. Minimum Requirements: Requires BA/BS..., which would provide an equivalent background. Current, unrestricted RN license in applicable state required. Multi-state licensure...
of care for hospitalized members by carrying out daily utilization and quality review, monitoring for inefficiencies... of experience in utilization review, case management, and discharge planning preferred. Bachelors Degree in Nursing, Health Care...
. In collaboration with Utilization Review, the SW CM will initiate and facilitate discussions with the payors to act as an advocate... manner, coordinating directly with the patient/family as well as the care team. Through continuous assessment and review, the...
utilization and quality review, monitoring for inefficiencies and opportunities to improve care, developing a safe discharge plan... of professional practice experience in an acute care setting. Minimum two (2) years of experience in utilization review, case...
which reflects favorably upon the organization. In collaboration with Utilization Review, the SW CM will initiate and facilitate... as the care team. Through continuous assessment and review, the SW CM will apply critical thinking to ensure alignment...
. In collaboration with Utilization Review, the SW CM will initiate and facilitate discussions with the payors to act as an advocate... manner, coordinating directly with the patient/family as well as the care team. Through continuous assessment and review, the...
. In collaboration with Utilization Review, the SW CM will initiate and facilitate discussions with the payors to act as an advocate... manner, coordinating directly with the patient/family as well as the care team. Through continuous assessment and review, the...
of care for hospitalized members by carrying out daily utilization and quality review, monitoring for inefficiencies... of experience in utilization review, case management, and discharge planning preferred. Bachelors Degree in Nursing, Health Care...
. Assists with development of utilization/care management policies and procedures. Minimum Requirements: Requires a BA/BS... an equivalent background. Current, unrestricted RN license from the State of Georgia required. Multistate licensure...
with providers, claims or service issues. Assists with development of utilization/care management policies and procedures...; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license...
are managed, evaluated, and capture accurate resource utilization at all the facilities levels. Partner with the Clinical... and Responsibilities: Develop and implements case management and clinical reimbursement programs. Review weekly/monthly RUG...
or utilization review is preferred Preferred and Required Minimum Skills: Strong understanding of disease processes, clinical... that reflects the appropriate utilization, clinical severity, outcomes, and quality for the level of service provided...
management or utilization review is preferred Preferred and Required Minimum Skills: Strong understanding of disease processes... the appropriate utilization, clinical severity, outcomes, and quality for the level of service provided to all patients...