- InnovaCare (San Juan, PR)
- …customer focus to the business. MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the ... Inpatient within forty-eight (48) hours of having performed the first concurrent review of notified admission cases.4. On a daily basis, concurrently reviews… more
- Centene Corporation (Sacramento, CA)
- …based on diagnoses, prognoses, resources, and/or preferences + Manages and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Provides education to providers on… more
- Centene Corporation (Tallahassee, FL)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- HCA Healthcare (Nashville, TN)
- …and integrity. We care like family! Jump-start your career as a(an) CDI Concurrent Review and Query Specialist WFH today with HCA Healthcare. **Benefits** ... by location._** Come join our team as a(an) CDI Concurrent Review and Query Specialist WFH. We...care facility required Licenses, Certifications, & Training: + Registered Nurse - Currently licensed as a Registered Professional … more
- Trinity Health (Fresno, CA)
- …maintaining current knowledge of clinical indicators and compliance requirements, conducting concurrent medical record review to ensure documentation compliance ... Health Science, or related field is preferred. 2. Current licensure as a Registered Nurse in the State of California is required. 3. Thorough knowledge of healthcare… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring the ... receives and reviews notification of emergent hospital admissions, completes inpatient concurrent review , establishes discharge plans, coordinates transitions of… more
- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a(an) Utilization Review Nurse BH WFH you want with your current employer? We have an ... colleagues. Do you want to work as a(an) Utilization Review Nurse BH WFH where your passion... as needed for authorization procurement and mitigation of concurrent denials. You will assess medical records for appropriateness,… more
- Independent Health (Buffalo, NY)
- …perks, benefits and commitment to diversity and inclusion. **Overview** The Utilization Review Nurse performs clinical reviews to determine the medical necessity ... services: (medical necessity review for Prior Authorization, pre-certification and concurrent review .) + Prompt, courteous, and error free in performing… more
- HCA Healthcare (Richmond, VA)
- …set us apart from any other healthcare provider. We are seeking a(an) Peer Review Coordinator Registered Nurse RN to join our healthcare family. **Benefits** ... - and empowers their passion for patient care. Apply today for our Peer Review Coordinator Registered Nurse RN opportunity. **Job Summary and Qualifications** +… more
- Travelers Insurance Company (Buffalo, NY)
- …Imagine loving what you do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview** The annual base salary range provided ... the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for prospective, … more
- McLaren Health Care (Bay City, MI)
- …documentation is sufficient to support the level of care being billed . Conducts concurrent reviews as directed in the hospital's UR Plan of medical records to ... **Essential Functions and Responsibilities:** 1. Performs a variety of concurrent and retrospective utilization management-related reviews and functions to ensure… 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
- UNC Health Care (Rocky Mount, NC)
- …ensure authorization for services is obtained and completes necessary appeals for concurrent or discharged patients. 5. Consults with Physician Advisors to assist ... license without sanctions)** Preferred Certifications & Licensures + Utilization Review or other applicable certification **Professional Experience Requirements:** +… more
- LA Care Health Plan (Los Angeles, CA)
- …in any inpatient setting. Performs telephonic and/or on site admission and concurrent review , and collaborates with onsite staff, physicians, providers, member/ ... Utilization Management Nurse Specialist LVN II Job Category: Clinical Department:...if indicated. Perform telephonic and/or on site admission and concurrent review , and collaborates with onsite staff,… more
- Ventura County (Ventura, CA)
- …variances to support active and timely performance improvement. Assists the TPM with concurrent review and the coordination patient care within the program as ... Of Duties Duties include but are not limited to the following: + Conducts concurrent Level I review of patients within the program throughout their hospital… more
- LA Care Health Plan (Los Angeles, CA)
- …in any inpatient setting. Performs telephonic and/or onsite admission and concurrent review , and collaborates with onsite staff, physicians, providers, ... Utilization Management Nurse Specialist RN II Job Category: Clinical Department:...productive workplace environment. Perform telephonic and/or onsite admission and concurrent review , and collaborates with onsite staff,… more
- HCA Healthcare (Las Vegas, NV)
- …clinical data compiled by hospital medical records for the purpose of admission/ concurrent review for Medicare and self-pay patients + Identifies potential ... you passionate about delivering patient-centered care?** Submit your application for Registered Nurse Case Manager position and spend more time at the bedside with… more
- Hackensack Meridian Health (Neptune, NJ)
- …+ Attends and participates in weekly educational conferences. + Participates in concurrent performance improvement activities and on-going MR review activities. ... as a leader of positive change. The Clinical Documentation Specialist Registered Nurse facilitates improvement in the overall quality, completeness and accuracy of… more
- Mount Sinai Health System (New York, NY)
- …the clinical information requested by the managed care companies as part of the concurrent review in a timely fashion. * Provides clinical information requested ... The Case Manager is responsible for all aspects of case management/ utilization review for an assigned group of inpatients, ED patients and Observation ( RETU)… more
- Access Dubuque (Dubuque, IA)
- …assigned patients, including prior authorization, admission, precertification/certification/recertification, concurrent and retrospective review , associated ... Nurse Case Manager **MercyOne** 1 Positions ID: TRHEUS00534506MERCYO...director, nursing director, and finance department for appropriate medical/administrative review and management. Effectively manages length of stay and… more
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