- MetroHealth (Cleveland, OH)
- …patient care by ensuring the appropriate level of care at the point of entry. The utilization review nurse will work on defined patient populations and is ... in Nursing (applies to placements after 1/1/2017). Current Registered Nurse License State of Ohio. Minimum of five years...skills. Preferred: Two years of experience with case management, utilization review . Physical Demands: May need to… more
- CommuniCare Health Services Corporate (Cleveland, OH)
- … + Weekly visits to facilities for intervention, audit and training + Review resident clinical records for coverage, utilization , errors, assessments and ... Registered Nurse (RN), Mobile MDS Coordinator CommuniCare Health Services is currently looking for a Registered Nurse to fill the key position of RN Mobile MDS… more
- Elevance Health (Seven Hills, OH)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... 8am - 5pm CST or 8am - 5pm EST** The Med Mgmt Nurse is responsible for review of the most complex or challenging cases that require nursing judgment, critical… more
- BrightSpring Health Services (Canton, OH)
- …and submit to State Health Services Director and Assigned Director, Clinical Practice* Review utilization report at least monthly to ensure adequate hours on ... meetings* Chairs committees as applicable (eg safety, infection control, incident/accident review , human rights, etc.).* Participates in the development of the… more
- MetroHealth (Cleveland, OH)
- …engages others in that vision. Develops nursing research initiatives, fosters research utilization activities, and protects the rights of human subjects involved in ... a liaison between the Nursing Department and the Institutional Review Board (IRB) and Office of Compliance. Explores research...Possess a current license to practice as a Registered Nurse in the State of Ohio. Possess a current… more
- Fresenius Medical Center (Akron, OH)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- MetroHealth (Brooklyn Heights, OH)
- …with the care team in the provision of patient care. Performs a clinical review of selected patients to determine service needs. Coordinates the care of selected ... patients. Integrates and coordinates access and utilization management, proactive patient panel management, care facilitation, and...Possess a current license to practice as a Registered Nurse in the State of Ohio. 3 years of… more
- MetroHealth (Brooklyn Heights, OH)
- …with the care team in the provision of patient care. Performs a clinical review of selected patients to determine service needs. Coordinates the care of selected ... patients. Integrates and coordinates access and utilization management, proactive patient panel management, care facilitation, and treatment planning functions.… more
- Cleveland Clinic (Akron, OH)
- …compliance with all standards and favorable performance on safety, quality, utilization and experience metrics and participates in engraining the safety, quality ... + Support medical staff quality assurance activities such as peer review , ongoing professional practice evaluation, and focused professional practice evaluation. +… more
- Fresenius Medical Center (Cleveland, OH)
- …barriers to quality improvement. This includes promoting the adoption and utilization of Medical Advisory Board Recommended Algorithms and Standing Orders, clinical ... quality improvement tools and electronic applications. + Performs desk review of facility Quality Assessment and Performance Improvement (QAPI) documentation… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …health promotion projects. Directs the clinical abstraction process to coordinate chart review for HEDIS and report back findings to network providers. . Provides ... Master's degree preferred. . 8 years progressive health care experience in case, utilization , or quality management; 3 years of which are in management or high-level… more