• Concurrent Review Nurse

    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 ... within forty-eight (48) hours of having performed the first concurrent review of notified admission cases.4. On...hours connected and attend regional conference calls with CRN Supervisor and Regional AIMDs by planned phone calls, following… more
    InnovaCare (10/16/24)
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  • Supervisor Registered Nurse Case…

    HCA Healthcare (Houston, TX)
    …for reviewing, monitoring and reporting hospital utilization of resources through concurrent review according to pre-established guidelines and criteria and ... other healthcare provider. We are seeking a(an) Case Management Supervisor RN to join our healthcare family. **Benefits** Texas...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
    HCA Healthcare (08/28/24)
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  • Retention Bonus Available! - Supervisor

    Prime Healthcare (Passaic, NJ)
    …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... Criteria preferred. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/179762/retention-bonus-available%21 supervisor %2c-case-management registered- nurse /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySt. Mary's… more
    Prime Healthcare (10/26/24)
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  • Precertification Nurse

    NJM Insurance (Trenton, NJ)
    …obtain clinical information and updates needed to effectively and accurately perform concurrent review . + Identify medical and community needs and ... in clinical nursing (Med-Surg or Critical Care preferred), Utilization Management Review /Hospital concurrent reviews, and/or Case Management preferred. +… more
    NJM Insurance (11/06/24)
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  • CVOR Charge Nurse

    AdventHealth (Daytona Beach, FL)
    …to assist for improved performance and outcomes as needed.Provide guidance and review implementation and concurrent documentation by the nursing staff for ... the following shift. Perform the duties of a Registered Nurse in the delivery of safe, therapeutic and cost...and hospital setting. Responsibilities include the assurance that the supervisor and their staff adhere to the AdventHealth Corporate… more
    AdventHealth (09/21/24)
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  • Supervisor , Utilization Management

    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
    Centene Corporation (11/10/24)
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  • Supervisor , Clinical Care Coordination

    UPMC (Mckeesport, PA)
    UPMC McKeesport's Addiction Medicine Unit is searching for a Supervisor of Clinical Care and Discharge Planning! Join our dedicated team on UPMC McKeesport's ... care to individuals on their recovery journey. We are seeking an experienced Supervisor to oversee the programmatic and regulatory aspects of our Addiction Medicine… more
    UPMC (11/02/24)
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  • Utilization Review Specialist Senior

    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 ... utilization of ancillary services + Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials. + Preferred… more
    BayCare Health System (10/14/24)
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  • Physician Advisor

    WellSpan Health (York, PA)
    …cases for determination of level of care and verify need for peer to peer review -discuss with the CM nurse and/or attending physician as needed and then document ... of retrospective external appeal-and funnel those cases to the Supervisor of Utilization Management for expedition. + Reviews cases...CM nurses and the CMRN in charge of readmission review for concurrent quality review ,… more
    WellSpan Health (10/18/24)
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  • Child Behavioral Health Clinician

    Baystate Health (Holyoke, MA)
    …the treatment team, which may include a Psychiatrist, Psychiatric Advanced Practice Nurse , Supervisor , Behavioral Health Clinicians, Psychiatric Nurse and/or ... the direction of the Director of Behavioral Health, Program Manager, and/or Supervisor , the Behavioral Health Clinician I (BHC-I) in the Partial Hospital Program… more
    Baystate Health (10/29/24)
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  • RN- Adolescent Partial program

    WMCHealth (Kingston, NY)
    …Internal Applicant link Job Details: Summary of Job Purpose + The Registered Nurse , in collaboration with the Team, is responsible for providing quality patient care ... float to other Mental Health units as needed. + Review and sign off on all LMP orders daily....payor requirements, clinical documentation and authorization status. + Perform concurrent reviews and discharge reviews with payors to ensure… more
    WMCHealth (10/14/24)
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  • Medical Assistant

    Brockton Hospital (Brockton, MA)
    …of patient's/family's questions or issues related to vaccine administration. + Review medical records for up-to-date problem list including patient reported ... record. + Contribute to individual patient care planning. + Participate in the review of schedules and space needs; anticipate and suggest any needed changes in… more
    Brockton Hospital (11/14/24)
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  • Senior UM Coordinator

    Brighton Health Plan Solutions, LLC (New York, NY)
    …Management services to its clients. Senior UM Coordinators facilitate utilization review by performing data collection, data entry, and effectively communicating ... with Nurse reviewers and leaders' employers and claimants regarding their...and claimants regarding their requests for preservice, prospective, and concurrent reviews. The Senior UM Coordinator reports to the… more
    Brighton Health Plan Solutions, LLC (11/08/24)
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  • Utilization Management Reviewer - Behavioral…

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …to facilitate care. Your Day to Day : + Conduct pre-certification and concurrent and retrospective clinical review of in-state and out-of-state inpatient cases ... member care and ensure a constructive provider experience + Facilitate review process by communication with members/families, providers, medical staff and/or others… more
    Blue Cross Blue Shield of Massachusetts (10/25/24)
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