- CHRISTUS Health (Wake Village, TX)
- …Physician Advisor or CMO when discrepancies are present. * Performs the initial clinical medical necessity review utilizing evidence-based criteria and ... Description Summary: The Registered Nurse Clinical Care Coordinator is responsible...management of patients in Observation status to include repeated review of clinical and opportunities for conversion… more
- CareFirst (Cumberland, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and ... programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Clinical Medical Review **Equal Employment Opportunity**… more
- System One (Baltimore, MD)
- …requirements. + Medical Record Retrieval, Abstraction and Research during the Medical Record Review Project + Medical Record Retrieval for ... ALTA IT Services is staffing a contract opportunity for a Clinical HEDIS Specialist support a leading health insurance customer. The main duties include conducting… more
- Hackensack Meridian Health (Little Falls, NJ)
- …educate and support appropriate documentation for coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed ... issues to the Director of the certified operation, Hospice Clinical Director, and the Nurse Manager for...clinical audits. Trend data obtained from reports and review results with managers. + Identify areas for improvement… more
- Hackensack Meridian Health (Brick, NJ)
- …educate and support appropriate documentation for coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed ... issues to the Director of the certified operation, Hospice Clinical Director, and the Nurse Manager for...clinical audits. Trend data obtained from reports and review results with managers. + Identify areas for improvement… more
- Centene Corporation (New York, NY)
- …be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... cost effectiveness of medical care. + Performs medical necessity and clinical reviews of authorization...with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive… more
- Elevance Health (Harrisburg, PA)
- ** Clinical Review Nurse Sr.**...make an impact:** + Responds to the most complex medical issues. + May participate in cross-functional teams, projects, ... 8 am - 4:30 EST. Hours are flexible.** The ** Clinical Review Nurse Sr** ....nurses, or utilization nurses. + Comprehends complex policies and medical criteria as it pertain to members. **Minimum Requirements:**… more
- CommonSpirit Health Mountain Region (Durango, CO)
- …flourish and leaders who care about your success. Assist with training and coordinating clinical review and quality assurance. Lead and review the ... clinical care and documentation practices related to patients/residents. Review and evaluate quality data to determine areas needing...of the home health and/or hospice patient. + Registered Nurse + Valid CO Driver's License. + BLS Sedentary… more
- Centene Corporation (Madison, WI)
- …be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies… more
- Fresenius Medical Center (New York, NY)
- …regulatory requirements and programs. Collaborates with the Medical Director and the Clinical Coordinator /Charge Nurse or Nurse Supervisor regarding the ... + Addressing patient concerns, issues, and questions including the review of patient satisfaction surveys. + Developing and communicating...with the Clinical Coordinator /Charge RN or Nurse Supervisor and Medical Director to implement… more
- HCA Healthcare (Englewood, CO)
- …HealthONE Swedish we support our colleagues in their positions. Join our Team as a(an) Clinical Nurse Coordinator Medical Acute Care and access programs to ... gain certifications and job skills. Apply today for our Clinical Nurse Coordinator Medical Acute...Medical Acute Care opening. Our team will promptly review your application. Highly qualified candidates will be contacted… more
- HCA Healthcare (Anchorage, AK)
- …Regional Hospital we support our colleagues in their positions. Join our Team as a(an) Clinical Nurse Coord Medical - Oncology and access programs to assist ... gain certifications and job skills. Apply today for our Clinical Nurse Coord Medical -...Medical - Oncology opening. Our team will promptly review your application. Highly qualified candidates will be contacted… more
- Rush University Medical Center (Chicago, IL)
- **Job Description** Med Surg Oncology Clinical Nurse Leader **Location:** Chicago, IL **Hospital:** RUSH University Medical Center **Department:** 14 W Tower ... 8 Hr (7:00:00 AM - 3:30:00 PM) **Summary:** The Clinical Nurse Leader (CNL) functions as an...+ Demonstrated ability to navigate and utilize an electronic medical record. + Demonstrates population-specific clinical knowledge… more
- Rush University Medical Center (Chicago, IL)
- **Job Description** **BMT Clinical Nurse Leader** **Location:** Chicago, IL **Hospital:** RUSH University Medical Center **Department:** 14 E Tower (BMT/Heme ... 8 Hr (7:00:00 AM - 3:30:00 PM) **Summary:** The Clinical Nurse Leader (CNL) functions as an...* Demonstrated ability to navigate and utilize an electronic medical record. * Demonstrates population-specific clinical knowledge… more
- Medical Mutual of Ohio (OH)
- …provider community, explaining processes for accessing health plan to perform clinical review , identifying appropriate community resources, or otherwise ... pre-employment substance abuse and nicotine testing._ \#LI-REMOTE **Title:** _Registered Nurse Clinical Appeal & Claim_ **Location:** _Ohio_ **Requisition… more
- Cleveland Clinic (Independence, OH)
- …and the Governing Body of the applicable hospitals. **CNS** + Currently licensed as a Clinical Nurse Specialist in applicable state(s). + Must be licensed as an ... medical care may be in a variety of clinical settings. PA's are privileged by the Board of...RN in applicable state(s). + National certification as a Clinical Nurse Specialist by nationally accredited organization… more
- Penn State Health (Hershey, PA)
- …for assistance._ **Union:** Non Bargained IND123 **Position** RN Registered Nurse Clinical Staff Leader - VARIED SHIFTS - Medical Intermediate Care Unit ... Rosado at ###@pennstatehealth.psu.edu (MAILTO://###@pennstatehealth.psu.edu) **SUMMARY OF POSITION:** The Registered Nurse Clinical Staff Leader will ensure … more
- Cleveland Clinic (Cleveland, OH)
- …and the Governing Body of the applicable hospitals. **CNS** + Currently licensed as a Clinical Nurse Specialist in applicable state(s). + Must be licensed as an ... medical care may be in a variety of clinical settings. PA's are privileged by the Board of...RN in applicable state(s). + National certification as a Clinical Nurse Specialist by nationally accredited organization… more
- Cleveland Clinic (Independence, OH)
- …and the Governing Body of the applicable hospitals. **CNS** + Currently licensed as a Clinical Nurse Specialist in applicable state(s). + Must be licensed as an ... Care is looking to add a Physician Assistant or Nurse Practitioner to our Medical Care at...RN in applicable state(s). + National certification as a Clinical Nurse Specialist by nationally accredited organization… more
- Penn State Health (Enola, PA)
- …Applicants PDF for more detailed steps for assistance._ IND567 **Position** Registered Nurse Clinical Staff Leader - Medical /Surgical **Location** ... Rush at ###@pennstatehealth.psu.edu (MAILTO://###@pennstatehealth.psu.edu) **SUMMARY OF POSITION:** The Registered Nurse Clinical Staff Leader will ensure … more
