- Emanate Health (Covina, CA)
- …decisions using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete ... States, and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity… more
- Diversicare Healthcare Services & Diversicare Ther (Tupelo, MS)
- …and completes accurate coding of the MDS assessment with information obtained via medical record review , observation and interview with center staff, patients, ... and residents, **APPLY NOW!** **Full Time Benefits include:** + ** Medical /Dental/Vision** + **Excellent 401k plan** + **Tuition Reimbursement** + **Vacation,… more
- Veterans Affairs, Veterans Health Administration (Temple, TX)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... services through an interdisciplinary team that includes the PCP, RN care manager, LVN , clerical associate as well as other clinical services necessary to meet the… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …of care). All Physicians are responsible to read and comply with the Medical Staff Bylaws. All physicians are responsible to timely complete all mandatory training. ... services through an interdisciplinary team that includes the PCP, RN care manager, LVN , clerical associate as well as other clinical services necessary to meet the… more
- Centene Corporation (Topeka, KS)
- …equivalent work experience within a managed care environment related to HEDIS record review , quality improvement, medical coding or transferable skill sets that ... performance in areas of Quality, Risk Adjustment and Operations ( claims and encounters). + Assists in delivering provider specific...Experience: Required: 1+ year of experience in related HEDIS medical record review or quality improvement with… more