- Centene Corporation (Sacramento, CA)
- …competitive benefits including a fresh perspective on workplace flexibility. **Fully Remote position that requires a CA RN Licensure.** **Position Purpose** : ... Performs concurrent reviews, including determining member's overall health, reviewing the...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- HCA Healthcare (Nashville, TN)
- …environment where diversity and inclusion thrive? Submit your application for our CDI Concurrent Review and Query Specialist opening with HCA Healthcare today ... **Description** This is a fully remote role, but you must live within 60...may vary by location._** We are seeking a(an) CDI Concurrent Review and Query Specialist for our… more
- HCA Healthcare (Nashville, TN)
- …colleagues invested over 156,000 hours volunteering in our communities. As a(an) CDI Concurrent Review and Query Specialist with Work from Home you can ... **Description** This is a fully remote role, but you must live within 60...our organization. We are looking for an enthusiastic CDI Concurrent Review and Query Specialist to help… more
- Centene Corporation (Sacramento, CA)
- …providers, as appropriate, for any discrepancies between prior authorization and concurrent review processes to ensure clinically appropriate determinations + ... benefits including a fresh perspective on workplace flexibility. Fully Remote Position that requires California RN Licensure. **Position Purpose:** Performs… more
- Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
- Summary The Emergency Department Utilization Management (ED-UM) Registered Nurse (RN) is responsible for providing competent, evidence-based practices within the ... management/clinical assessment on all patients reviewed in the ED. Conducts initial review using InterQual, and other tools, and assists provider in correct… more
- HCA Healthcare (Corpus Christi, TX)
- …Medical Center Bay Area!** **Job Summary and Qualifications** **The Quality Review Nurse position encompasses multiple responsibilities including Core Measure ... chart abstraction, Stroke & STEMI chart review and coordination; performs concurrent chart reviews...path, we encourage you to apply for our Registered Nurse Clinical Reviewer PRN opening. We review … more
- HCA Healthcare (Mcallen, TX)
- …benefits may vary by location._ **Job Summary and Qualifications** The Review Nurse Clinical Reviewer position encompasses multiple responsibilities including ... about delivering patient-centered care? Submit your application for Registered Nurse Quality position and spend more time at the...Core Measure chart abstraction, Stroke & STEMI chart review and coordination; performs concurrent chart reviews… more
- CVS Health (Carson City, NV)
- …1 year of varied UM (utilization management) experience within an inpatient/outpatient setting, concurrent review or prior authorization. + Required to use a ... make health care more personal, convenient and affordable. **Position Summary** **100% remote position from anywhere in the US** **Work hours: 11:30am-8:00pm EST,… more
- Geisinger (Danville, PA)
- …provided. The core of the program uses highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to be coded ... mortality, severity of illness; and initiate documentation of the review . + Pursues a subsequent review of...site in Danville, PA and it is NOT a remote position. Hours: 40 hours per week; Dayshift Weekends:… more
- International Medical Group (Indianapolis, IN)
- …an active RN license in good standing in Indiana. + Location: Hybrid or Remote working options. + Corporate office is in Indianapolis, IN. + Relocation Expenses ... of the use of health care services, procedures, and facilities for utilization review and /or /evacuation/repatriation. Work as a liaison between the Insured, the… more
- BrightSpring Health Services (Martinsburg, WV)
- …Registered Professional Nurse + Excellent communicator with ability to handle concurrent tasks and responsibilities + Ability to travel within assigned area + ... meetings + Chairing committees as appropriate, safety, infection control, incident review , and human rights committees + Facilitating communication and serving as… more
- AdventHealth (Altamonte Springs, FL)
- …we are even better. **Shift** : Full-time; Monday-Friday **Job Location** : Remote **The role you'll contribute:** Under general supervision of the Director of ... in the management of resources entrusted to them. . Reviews concurrent medical record for documentation compliance including completeness and accuracy for… more
- Providence (Beaverton, OR)
- …Planning, Coordination of Outpatient Care) + Utilization Management Experience (EX. Concurrent Review , Prior Authorization, Medical Audits, Appeals or ... planning, acute and catastrophic case management + Care management services include: nurse education, care coordination and general assistance with managing day to… more
- GE Vernova (Wilmington, NC)
- …change control, and configuration management. + Perform design technical oversight, review , and verification of deliverables to ensure their adequacy in; accuracy, ... contact for Regulatory Affairs or Licensing for preparation or review and comment of; Preliminary Safety Analysis Report (PSAR),...Headquarters in Wilmington, NC; but highly qualified (US based) remote candidates will be considered. + This role is… more
- GE Vernova (Wilmington, NC)
- …as GEH is the systems integrator. + Perform design technical oversight, review , and verification of deliverables to ensure their adequacy in; accuracy, completeness, ... the GEH Headquarters in Wilmington, NC; but highly qualified (US based) remote candidates will be considered. **Desired Qualifications:** + Masters in Engineering… more
- Providence (OR)
- …Planning, Coordination of Outpatient Care) + Utilization Management Experience (EX. Concurrent Review , Prior Authorization, Medical Audits, Appeals or ... planning, acute and catastrophic case management + Care management services include: nurse education, care coordination and general assistance with managing day to… more
- CareFirst (Baltimore, MD)
- …**PURPOSE:** Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent and retrospective ... Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist, will analyze clinical information, contracts, mandates, medical… more
- LifePoint Health (Brentwood, TN)
- …oversight and day-to-day implementation and management of processes related to the concurrent review of the clinical documentation in the inpatient medical ... attendance. . Perform other duties as assigned. *What you'll need:* *Education: * Nurse (RN, NP, or graduate of a state approved nursing program),*or*Physician (MD,… more
- VNS Health (Manhattan, NY)
- …general supervision. Compensation Range:$85,000.00 - $106,300.00 Annual * Conducts comprehensive review of all components related to requests for services which ... includes a clinical record review and interviews with members, clinical staff, medical providers,...care and lengths of stay. Performs prior authorization and concurrent reviews to ensure extended treatment is medically necessary… more
- Molina Healthcare (Hattiesburg, MS)
- …management (Position oversees PA authorizations and manages the inpatient certification review staff for initial, concurrent , or retrospective reviews); ... long-term supports and services; or nurse advice line. + Develops, implements and/or monitors standardized protocols for clinical and non-clinical team activities to… more