- 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 ... may vary by location._** We are seeking a(an) CDI Concurrent Review and Query Specialist for our...care facility required Licenses, Certifications, & Training: + Registered Nurse - Currently licensed as a Registered Professional … more
- Ventura County (Ventura, CA)
- Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4591361) Apply Senior Medical Management ... health care services to County employees and their covered dependents. The Senior Registered Nurse -Ambulatory Care series is distinguished from other nursing… more
- Ascension Health (Tulsa, OK)
- …Connect with your Talent Advisor for additional specifics._ **Responsibilities** + Review admissions and service requests within assigned unit for prospective, ... concurrent and retrospective medical necessity and/or compliance with reimbursement...team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Ascension Health (Manhattan, KS)
- …health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within assigned ... unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement...team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- BayCare Health System (Clearwater, FL)
- …other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient ... and clinical excellence. **BayCare Health System** is currently seeking a **Utilization Review Specialist Senior ** to join our outstanding and compassionate… more
- Sacramento County (Sacramento, CA)
- …Employment Qualifications Minimum Qualifications Either: One year of experience as a Senior Public Health Nurse in Sacramento County service. Or: Two ... improperly rejected may request the Employment Services Division to review its decision to reject the application. If the...+ I have one year of experience as a Senior Public Health Nurse in Sacramento County… more
- HCA Healthcare (Richmond, VA)
- …tasks. + Your Primary function in this role is to Performs admission and concurrent review for all payers and maintains legible documentation as directed by ... patient-centered care?** Submit your application for Case Manager Registered Nurse RN position and spend more time at the...a healthier tomorrow."- Jane Englebright, PhD, RN CENP, FAAN Senior Vice President and Chief Nursing Executive Join a… 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 ... DRG assignment, risk of mortality, severity of illness; and initiate documentation of the review . + Pursues a subsequent review of records every 3 days to… more
- Geisinger (Scranton, PA)
- …reporting potential risk and quality management issues identified from medical record review to appropriate departments through defined processes, and enters data as ... support quality improvement initiatives into appropriate system. + Conducts on-going case review for delays or variances in care; raises issues with appropriate… more
- Sacramento County (Sacramento, CA)
- Senior Mental Health Worker-Licensed Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/1036656) Apply Senior Mental Health Worker-Licensed ... plans with little direct supervision; provide direction to and review the work of assigned staff. + Establish and...the State of California to practice as a Registered Nurse , Vocational Nurse or Psychiatric Technician AND… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Senior Infection Preventionist position is responsible for implementing and maintaining the multiple facets of the Infection Control ... liaison between all departments and the Infection Control Committee. The Senior Infection Preventionist position maintains a routine surveillance program of… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …Brighton Health Plan Solutions provides Utilization Management services to its clients. Senior UM Coordinators facilitate utilization review by performing data ... leaders' employers and claimants regarding their requests for preservice, prospective, and concurrent reviews. The Senior UM Coordinator reports to the Manager,… more
- GE Vernova (Wilmington, NC)
- …and solving challenging problems. **Job Description** **Essential Responsibilities** + Senior Systems Engineer (LSE) for BWRX-300 Master Parts List (MPL) ... change control, and configuration management. + Perform design technical oversight, review , and verification of deliverables to ensure their adequacy in; accuracy,… more
- Centene Corporation (Tallahassee, FL)
- …RESIDE IN THE STATE OF FLORIDA.** **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical Review ... between utilization management team, members, and providers + Monitors prior authorization, concurrent review , and/or retrospective clinical review nurses… more
- UPMC (Mechanicsburg, PA)
- …position and requires a rotating weekend and holiday schedule.** **Purpose:** The Senior Care Manager (CM) coordinates the clinical and financial plan for patients. ... all Avoidable Days in CANOPY system. + Takes leadership role in concurrent denial process. Works with Care Management Director, Physician Advisor, Attending… more
- Sacramento County (Sacramento, CA)
- …clinic. OR: Two years of experience in the class of Mental Health Counselor, Psychiatric Nurse , Senior Mental Health Counselor, Senior Psychiatric Nurse , ... Licensed Clinical Social Worker, Marriage and Family Therapist, or Registered Nurse . AND Either: Two years of experience coordinating and/or supervising mental… more
- Catholic Health Initiatives (The Woodlands, TX)
- …role also serves as a resource to employees, management, nursing directors, senior management, councils, physicians and teams on quality management activities and ... experience, efficiency, FMEAS, root cause analyses and medical staff improvement (eg case review for peer review , OPPE, FPPE). Participates in an integral role… more
- HCA Healthcare (Rochester, NH)
- …us apart from any other healthcare provider. We are seeking a(an) RN Senior Clinical Quality Patient Safety Specialist to join our healthcare family. **Benefits** ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...department's quality and safety work through such activities as concurrent and retrospective abstraction of records to evaluation compliance… 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, ... of Examiners for Engineering and Surveying (NCEES). + PMI/PMP or MBA. + Senior Reactor Operator (SRO). + Experience in nuclear analog and digital instrumentation,… more
- Ascension Health (Nashville, TN)
- …continuing education initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully ... in utilization management to optimize patient care, and partner with the National Senior Director of UM to align on organizational goals. Ready to lead and… more