- TalentBurst, Inc (Irving, TX)
- …providers and vendors to obtain approved certification for services. The RN Utilization Review Nurse collaborates as necessary with other members of the health ... TalentBurst, Inc is seeking a travel nurse RN Utilization Review for a...- Irving TX 75039 JOB SUMMARY The RN Utilization Review II is responsible for determining the clinical… more
- UT Health Tyler (Tyler, TX)
- …care team. Plans and coordinates a comprehensive plan of care using a concurrent integrated review , standard operating procedures, case management tools, and ... team as a full-time, day shift, Case Manager Registered Nurse in Tyler, TX. Fulfilling your purpose begins here:...clinical outcomes. Communicates with third party payors, peer review entities and physicians' offices to gather and provide… more
- Centene Corporation (New York, NY)
- …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
- 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 ... compliance with the Plan's SNP policies and MOC requirements. Clinical staff who do not complete the required annual...within forty-eight (48) hours of having performed the first concurrent review of notified admission cases.4. On… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …in a UM team within managed care setting. + 3+ years experience in clinical nurse setting preferred. + TPA Experience preferred. About At Brighton Health ... BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs daily medical necessity reviews. This position reports to the… more
- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a CDI Concurrent Review Lead WFH you want with your current employer? We have an ... colleagues. Do you want to work as a CDI Concurrent Review Lead WFH where your passion...1+ year of experience in inpatient CDI + Registered Nurse - Currently licensed as a registered professional … more
- RWJBarnabas Health (Jersey City, NJ)
- Nurse Midwife(FT) Days- MMG Concurrent -Jersey CityReq #:0000106025 Category: Nurse Midwife Status:Full-Time Shift:Day Facility:Jersey City Medical Center ... Department:MMG Concurrent Location: Jersey City Medical Center, 355 Grand Street,...Street, Jersey CIty, NJ 07302 Job Overview- The Certified Nurse Midwife position provides antepartum, intrapartum, postpartum, neonatal and… more
- HCA Healthcare (Nashville, TN)
- …work environment where diversity and inclusion thrive? Submit your application for our CDI Concurrent Review and Query Specialist WFH opening with HCA today and ... may vary by location._** We are seeking a(an) CDI Concurrent Review and Query Specialist WFH for...to physicians for conflicting, imprecise, incomplete, illegible, or inconsistent clinical documentation. This individual need to function in a… more
- Trinity Health (Fresno, CA)
- …current knowledge of clinical indicators and compliance requirements, conducting concurrent medical record review to ensure documentation compliance and ... position offers vital support for improvement of quality and clinical performance. This position collaborates with clinical ...field is preferred. 2. Current licensure as a Registered Nurse in the State of California is required. 3.… more
- Martin's Point Health Care (Portland, ME)
- …as a "Great Place to Work" since 2015. Position Summary Job Description The Utilization Review Nurse works as a member of a team responsible for ensuring the ... receives and reviews notification of emergent hospital admissions, completes inpatient concurrent review , establishes discharge plans, coordinates transitions of… more
- Montana State University-Northern (Havre, MT)
- …is ten. The CRRN is responsible for the students and must have not have concurrent clinical responsibilities. The CRRN may also be assigned to monitor students ... Clinical Resource Registered Nurse (CRRN) part-time...position including any supplementary documentation and questions you should review before applying for the opening. To apply for… more
- Medical Mutual of Ohio (OH)
- …clinical experience as a Registered Nurse , including 1 year in a clinical quality review nurse role, care management, utilization management, medical ... + **Performs other duties as assigned.** **Qualifications** **Quality Safety Review Nurse ** **Education and Experience** + **Graduate...degree in related field a plus.** + **3 years clinical experience as a Registered Nurse , preferably… more
- HCA Healthcare (Houston, TX)
- …environment where diversity and inclusion thrive? Submit your application for our Registered Nurse Clinical Reviewer opening with The Woman's Hospital of Texas ... may vary by location._ We are seeking a(an) Registered Nurse Clinical Reviewer for our team to...including Core Measure chart abstraction, Stroke & STEMI chart review and coordination; performs concurrent chart reviews… 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 ... Job Summary The Clinical Documentation Improvement Program (CDI) is designed to...mortality, severity of illness; and initiate documentation of the review . + Pursues a subsequent review of… more
- HCA Healthcare (Corpus Christi, TX)
- …next step in your career path, we encourage you to apply for our Registered Nurse Clinical Reviewer opening. We review all applications. Qualified candidates ... Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer you want in your...including Core Measure chart abstraction, Stroke & STEMI chart review and coordination; performs concurrent chart reviews… more
- HCA Healthcare (Corpus Christi, TX)
- …your career path, we encourage you to apply for our Registered Nurse Clinical Reviewer PRN opening. We review all applications. Qualified candidates will be ... **Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer PRN you want in...including Core Measure chart abstraction, Stroke & STEMI chart review and coordination; performs concurrent chart reviews… more
- HCA Healthcare (Houston, TX)
- **Description** **Introduction** **Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer you want in your current role? We invest in ... HCA Houston Healthcare Northwest!** **Job Summary and Qualifications** **The Quality Review Nurse position encompasses multiple responsibilities including Core… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of the Utilization Review Team and ... reviewing claims disputes and retrospective requests for services requiring clinical review prior to payment. The Utilization... review prior to payment. The Utilization Review Nurse will use appropriate governmental policies… more
- Beth Israel Lahey Health (Burlington, MA)
- …being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for ... duties as required and directed. **Qualifications:** Required Licensure as a Registered Nurse (RN), Massachusetts Three years of recent clinical or utilization… more
- Beth Israel Lahey Health (Needham, MA)
- …being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for ... a Registered Nurse (RN), Massachusetts + Three years of recent clinical or utilization management experience _Preferred:_ + Bachelor's degree in nursing or… more
