- 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 (Olympia, WA)
- …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
- The Cigna Group (Bloomfield, CT)
- The Registered Nurse will: + Perform clinical and operational processes related to transition / coordination of care and utilization / case management of Post-Acute ... rehab facilities, home health care, care management, and utilization review . + Implement, evaluate and coordinate the plan of...or Bachelor Degree in Nursing + Current unrestricted Registered Nurse licensure in the state of residence + Multistate… more
- Molina Healthcare (Phoenix, AZ)
- …a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review / Utilization Review / Utilization Management and knowledge of ... can be flexible and willing to work some weekends and holidays. This is a remote position and you may work from home._** **_Further Details to be discussed during… more
- Ascension Health (Birmingham, AL)
- …required. + **Hospital:** Ascension St. Vincent's Birmingham + **Location:** Birmingham, AL ( remote ) At least 3 years of acute care experience and utilization ... health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within assigned… more
- University of Michigan (Ann Arbor, MI)
- Nurse Informaticist-Expert/ Nurse Informaticist-Competent Apply Now **How to Apply** A cover letter is required for consideration for this position and should be ... that directly relate to this position. **Job Summary** A Nurse Informaticist is a registered nurse who...and stages + Ability to prioritize and lead multiple concurrent projects + Ability to work in a dynamic… more
- Tufts Medicine (Burlington, MA)
- …and regulatory compliance related to the CDI and coding functions. 2. Performs initial concurrent review of new patients every day and concurrent re-reviews ... **Location: 100% Remote ** **Job Profile Summary** This role focuses on...Overview** The role of the position is responsible for concurrent and retrospect review and analysis of… 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
- Johns Hopkins University (MD)
- …knowledge and application of OSHA/JHU/client regulations and safety standards. + Review each clinic's return on investment strategy to ensure appropriateness. + ... Refrigerator temps, CLIA expiration, and Sharps/Stericycle logs to ensure quality control. + Review Cority / DOT forms and EMR to ensure appropriate and thorough… 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 ... Case Mix Index. Note: this position is not a remote position Job Duties + Reviews inpatient medical records...mortality, severity of illness; and initiate documentation of the review . + Pursues a subsequent review of… more
- Tufts Medicine (Burlington, MA)
- …an all-inclusive list. Other duties and responsibilities may be assigned. 1. Performs initial concurrent review of new patients every day and concurrent ... Location: 100% Remote **Job Profile** **Summary** This role focuses on...job area. **Job Overview** The position is responsible for review and analysis of the medical record to improve… 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
- AdventHealth (Orlando, FL)
- …stewardship in the management of resources entrusted to them. + Reviews concurrent medical record for compliance including completeness and accuracy for severity of ... of mortality (ROM) and quality. + Completes accurate and timely record review to ensure the integrity of documentation compliance. Completes accurate and concise… more
- AdventHealth (Altamonte Springs, FL)
- …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
- GE Vernova (Wilmington, NC)
- …oversight of suppliers thru procurement and construction to develop, perform, and review unit, module, system, and integration test plans, procedures, and reports ... Engineer-Procure-Construct (EPC) partner(s), and suppliers. + Perform detailed oversight, review , and verification of deliverables from suppliers to ensure their… more
- Providence (Vancouver, WA)
- …Planning, Coordination of Outpatient Care) + Utilization Management Experience (EX. Concurrent Review , Prior Authorization, Medical Audits, Appeals or ... nearing end of life + Care management services include: nurse education, care coordination and general assistance with managing...care to our members **Providence Health Plan welcomes 100% remote work for applicants who reside in the following… 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
- Magellan Health Services (San Diego, CA)
- …person-centered care plan, member education and care management. Conducts initial and concurrent review for prior authorization of higher levels of care ... This is a remote position and candidates must be licensed in...Licensed Professional Counselor - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt… more
- Centene Corporation (Baton Rouge, LA)
- …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... competitive benefits including a fresh perspective on workplace flexibility. **Location: Remote . Candidate must reside in Louisiana** **Hours: Schedule will be… more