- 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 (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
- Centene Corporation (Sacramento, CA)
- …providers, as appropriate, for any discrepancies between prior authorization and concurrent review processes to ensure clinically appropriate determinations + ... quality of care issues, and if identified, refer to the Medical Director or provider for review and verification + Consults with senior management and healthcare… more
- Banner Health (AZ)
- …thoroughly completes documentation required for claims payment of services approved through concurrent review and case management. 7. Works independently under ... by including remote and hybrid opportunities. As a Registered Nurse Reviewer, you will work a critical part of...company facilities or other staff of non-company locations on concurrent and retrospective utilization review . Accurately and… 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
- The Cigna Group (Bloomfield, CT)
- This position, the Nurse Case Manager Senior Analyst, through the case management process, will promote the improvement of health outcomes to members and assist ... addition to Case Management duties, the Case Manager will manage precert and concurrent reviews for the transplant members assigned to their caseload. This will… 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 (Chapel Hill, NC)
- …concurrent reviews. The Senior Care Coordinator reports to the Senior Nurse Manager, Utilization Management. Primary Responsibilities + Partner with ... to its clients. Care Coordinators facilitate care management and utilization review by performing data collection, data entry, and effectively communicating with… more
- MD Anderson Cancer Center (Houston, TX)
- …and research nurse are notified in a timely fashion. Performs ongoing and concurrent review of data to ensure completeness and accuracy. Addresses data entry ... **SUMMARY** The primary purpose of the Senior Research Data Coordinator for the Department of...records of study eligibility, pathology reports and specimens for review /confirmation, surgery reports, therapy dates, laboratory results, and follow… 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
- Vanderbilt University Medical Center (Nashville, TN)
- …procedures independently. Documents the patient's clinical status and care provided. Performs concurrent review of patient records for documentation to support ... of emphasizing negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC-Registered Nurse - Licensure-Others **Work Experience:** Relevant Work Experience **Experience… more
- Ascension Health (Austin, TX)
- **Details** + **Department:** UR Review + **Schedule:** FT - Days + **Location:** Austin, TX - Remote after 4 weeks of training onsite **Benefits** Paid time off ... health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within assigned… more
- Ascension Health (Milwaukee, WI)
- …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
- 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
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