- CommonSpirit Health Mountain Region (Centennial, CO)
- …has an integral role within the revenue cycle by providing clinical expertise in the denials management process. The Denials RN performs a root cause ... will need the following: Required: Minimum three (3)years clinical experience as Registered Nurse (RN) required. Preferred: * Graduate of an accredited… more
- St. Mary's Healthcare (Amsterdam, NY)
- …of nursing required. Licensure / Certification / Registration: Required Credential(s): * Registered Nurse credentialed from the New York Board of Nursing. ... recognize and resolve billing inconsistencies. * Reviews commercial and government claim denials and audit requests and coordinates attempts to overturn denials … more
- WellSpan Health (York, PA)
- …+ 3 years Utilization Management Experience. Preferred Licenses: + Licensed Registered Nurse Preferred Knowledge, Skills, and Abilities: + Advanced computer ... Director-Utilization and Denials Management Location: WellSpan Health, York, PA Schedule: Full Time General Summary Supervises and oversees the operations of the… more
- SSM Health (OK)
- …or education equivalency for licensing EXPERIENCE + Three years hospital acute care registered nurse experience, with one year experience in utilization review ... Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse (RN) Issued by Compact State + Or + Registered… more
- HCA Healthcare (Houston, TX)
- …appropriate. **What qualifications you will need:** + Bachelor's degree Nursing preferred + Registered Nurse - Currently licensed as a registered ... any other healthcare provider. We are seeking a(an) Case Management Supervisor RN to join our healthcare family. **Benefits**...Support + Registered Social Worker (RSW), or Registered Nurse , or Certified Care Manager (CMC)… more
- Geisinger (Danville, PA)
- …and License(s) Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... of care using predetermined criteria, reporting potential risk and quality management issues identified from medical record review to appropriate departments through… more
- Geisinger (Scranton, PA)
- …Experience Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE ... of care using predetermined criteria, reporting potential risk and quality management issues identified from medical record review to appropriate departments through… more
- AdventHealth (Altamonte Springs, FL)
- …CERTIFICATION OR REGISTRATION REQUIRED:** * Basic Life Support - CPR Cert * Registered Nurse This facility is an equal opportunity employer and complies ... Ethics, the ANA Scope and Standard for Nursing Practice, and the AONE Nurse Executive Competencies. *Liaises between Care Management , Nursing, and Hospital… more
- Bon Secours Mercy Health (Portsmouth, VA)
- …+ Verifies patient's needs for acute level of care, collaborating with utilization management nurse to prevent potential denials . The care manager ... supporting patients that would benefit from and need care management services. **This is a PRN position at Maryview...position at Maryview Medical Center** Licensing/ Certification + Acute Registered Nurse (RN) (required) + BLS Basic… more
- Bon Secours Mercy Health (Newport News, VA)
- …benefit from and need care management services. **Licensing/ Certification** + Acute Registered Nurse (RN) (required) + BLS Basic Life Support - American ... Verifies patient's needs for acute level of care, collaborating with utilization management nurse to prevent potential denials . The care manager will address… more
- Sutter Health (San Francisco, CA)
- …Other: Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN- Registered Nurse of California CCM - Certified Case Manager (certification ... Pacific Med Center Davies **Position Overview:** Coordinates the utilization management , resource management , discharge planning, post-acute care referrals… more
- Sharecare, Inc. (Columbus, OH)
- …in influencing patient and provider outcomes **Qualifications:** + Current multi-state/compact Registered Nurse licensure in state of residence is required, ... delivery of Sharecare's Advocacy program by providing high quality telephonic/digital Case Management and/or condition management in a virtual call center… more
- AdventHealth (Celebration, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... The RN Care Manager is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of post-hospital needs;… more
- AdventHealth (Altamonte Springs, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... The RN Care Manager is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of post-hospital needs;… more
- Ascension Health (Manhattan, KS)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing ... **Details** + **Department:** Utilization Management + **Schedule:** Full Time, 40 hours weekly, Monday - Friday 7:30am - 4pm + **Hospital:** Ascension Via Christi… more
- Ascension Health (Tulsa, OK)
- … rules and regulations. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Oklahoma Board of Nursing obtained ... **Details** + **Department:** Utilization Management + **Schedule:** FT, Monday-Friday, 8:30am-5:00pm + **Hospital:** Ascension St. John Medical Center +… more
- Pipeline Health System, LLC (Gardena, CA)
- …These include utilization review, discharge planning, care coordination and variance management to assure the delivery of necessary services, efficient patient ... care and wise utilization of resources. + Documents case management activities in the patient record and in the...interdisciplinary team. Communicates expected discharges to the unit charge nurse , patient unit and family. + Identifies patients at… more
- AdventHealth (Winter Garden, FL)
- …The RN Care Manager is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of post-hospital needs, ... patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the interdisciplinary team… more
- Trinity Health (Darby, PA)
- …construction of professional appeals in response to denied claims. **Qualifications:** + PA Registered Nurse or Licensed Vocational Nurse /Licensed Practical ... Shift **Description:** Trinity Health Mid-Atlantic is looking for Clinical Pre-Service Nurse Coordinator to join our Pre-Service team! **Employment Type:** Full Time… more
- Genesis Healthcare (Philadelphia, PA)
- …needed, facilitates communication with designated billing/business offices in support of Denials Management process.Provides regulatory and payer policy guidance ... in accordance with department policiesPerforms other duties as requested.Qualifications: Registered Nurse .Significant experience in the Healthcare Industry.Knowledge… more