• Quality Concurrent Reviewer

    Trinity Health (Fresno, CA)
    …Nursing, Health Science, or related field is preferred. 2. Current licensure as a Registered Nurse in the State of California is required. 3. Thorough knowledge ... maintaining current knowledge of clinical indicators and compliance requirements, conducting concurrent medical record review to ensure documentation compliance… more
    Trinity Health (09/28/24)
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  • 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 ... confers daily regarding patient and physician related issues.8. Performs concurrent quality review and reports...* Bachelor's Degree in Science of Nursing. * Current RN permanent license in Puerto Rico and Collegiate. *… more
    InnovaCare (10/16/24)
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  • Registered Nurse Clinical…

    HCA Healthcare (Corpus Christi, TX)
    …we encourage you to apply for our Registered Nurse Clinical Reviewer PRN opening. We review all applications. Qualified candidates will be contacted by ... **Introduction** **Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer PRN...Medical Center Bay Area!** **Job Summary and Qualifications** **The Quality Review Nurse position encompasses… more
    HCA Healthcare (11/01/24)
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  • RN Clinical Reviewer

    HCA Healthcare (Corpus Christi, TX)
    …in your career path, we encourage you to apply for our Registered Nurse Clinical Reviewer opening. We review all applications. Qualified candidates will ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer you...including Core Measure chart abstraction, Stroke & STEMI chart review and coordination; performs concurrent chart reviews… more
    HCA Healthcare (09/24/24)
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  • RN Clinical Documentation Specialist, First…

    SSM Health (MO)
    …Division of Professional Registration + Or + Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by Compact State + Or + Registered ... is responsible for facilitating the improvement in the overall quality and completeness of provider-based clinical documentation in the...+ Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by… more
    SSM Health (09/05/24)
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  • Case Manager

    Ellis Medicine (Schenectady, NY)
    …practice as a RN in New York State. Experience: Previous Utilization Review , Quality Assessment, Discharge Planning or Home Care experience is highly ... post admission with communication to insurance as needed. Does concurrent review on criteria and nursing judgment....continuum to plan best management plan. * Ensures effective concurrent Quality Assurance. Works closely with chiefs/QA… more
    Ellis Medicine (09/20/24)
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  • Case Manager Registered Nurse

    HCA Healthcare (Richmond, VA)
    …**Are you passionate about delivering patient-centered care?** Submit your application for Case Manager Registered Nurse RN position and spend more time at ... function in this role is to Performs admission and concurrent review for all payers and maintains...career! We are interviewing candidates for our Case Manager Registered Nurse RN opening. **Apply… more
    HCA Healthcare (10/09/24)
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  • Registered Nurse RN - Case…

    Trinity Health (Howell, MI)
    …weeks from 8 am to 5 pm Monday through Friday. **WHAT YOU WILL DO** + The RN Registered Nurse Case manager is responsible for conducting a focused assessment ... economic/financial and discharge planning needs. + One would also review , on a concurrent basis, the appropriateness,...and clinical risk issues and documentation completeness. + The RN Registered Nurse Case Manager… more
    Trinity Health (10/30/24)
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  • Registered Nurse RN - Case…

    Trinity Health (Ann Arbor, MI)
    …weeks from 8 am to 5 pm Monday through Friday. **WHAT YOU WILL DO** + The RN Registered Nurse Case manager is responsible for conducting a focused assessment ... economic/financial and discharge planning needs. + One would also review , on a concurrent basis, the appropriateness,...and clinical risk issues and documentation completeness. + The RN Registered Nurse Case Manager… more
    Trinity Health (10/29/24)
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  • Medicare Nurse Reviewer

    Medical Mutual of Ohio (OH)
    …Medicare Supplement, and individual plans. Under limited supervision, the Medicare Nurse Reviewer applies medical necessity guidelines in making authorization ... mind to more than 1.2 million members through our high- quality health, life, disability, dental, vision and indemnity plans....Board. Bachelor's degree preferred. + 3 years as a Registered Nurse with a combination of clinical… more
    Medical Mutual of Ohio (11/20/24)
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  • Registered Nurse ( RN ) Case…

    LifePoint Health (Henderson, NC)
    …state, or local law. **Job:** **Case Management/Social Services* **Organization:** ** **Title:** * Registered Nurse ( RN ) Case Manager Full Time* **Location:** ... awards programs . And much more *Position Summary* The RN Case Manager is responsible for the coordination of...skills. Requires a working knowledge of community resources and Utilization/ Quality Review standards and activities conducted by… more
    LifePoint Health (10/08/24)
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  • Utilization Management Reviewer

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …What You Bring : + Behavioral Health professional with an active Massachusetts license: Registered Nurse , LICSW, LMHC + 3-5 years of clinical experience in ... true colors to blue. The Role The Clinical Utilization Reviewer is responsible for facilitating care for members who...Your Day to Day : + Conduct pre-certification and concurrent and retrospective clinical review of in-state… more
    Blue Cross Blue Shield of Massachusetts (10/25/24)
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  • RN - Registered Nurse - Case…

    Geisinger (Bloomsburg, PA)
    …and License(s) Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... quality of care using predetermined criteria, reporting potential risk and quality management issues identified from medical record review to appropriate… more
    Geisinger (11/17/24)
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  • RN - Care Manager Registered

    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 ... quality of care using predetermined criteria, reporting potential risk and quality management issues identified from medical record review to appropriate… more
    Geisinger (11/09/24)
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  • HMSA Care Manager - BH, UM Reviewer

    Magellan Health Services (Honolulu, HI)
    …- Licensed Professional Counselor - Care Mgmt, LSW - Licensed Social Worker - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care ... with mental health and substance abuse issues, and participates in special quality improvement projects. + Monitors inpatient and/or outpatient level of care… more
    Magellan Health Services (11/21/24)
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  • Registered Nurse , RN - Case…

    Prime Healthcare (Lynwood, CA)
    …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/184015/ registered - nurse %2c- rn ... and to perform a holistic and comprehensive admission and concurrent review of the medical record for...an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April… more
    Prime Healthcare (11/22/24)
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  • Registered Nurse ( RN )…

    Prime Healthcare (Victorville, CA)
    …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5… more
    Prime Healthcare (11/13/24)
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  • Registered Nurse ( RN

    Northwell Health (Bay Shore, NY)
    …and assesses of patients admitted to the Hospital. Job Responsibility + * Performs concurrent review on all patients and share all problematic cases with the ... a liaison with patients insurance carrier (case manager, utilization reviewer ) to coordinate post hospital services and referrals. +...field, preferred. + Current license to practice as a Registered Professional Nurse in New York State.… more
    Northwell Health (11/19/24)
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  • Registered Nurse D/CF (Level I/II)

    Sacramento County (Sacramento, CA)
    …read and understood the above instructions. 02 Select the one box that best describes your Registered Nurse ( RN ) license issued by the State of California. + ... Registered Nurse D/CF (Level I/II) Print...examination will evaluate the relevance, level, recency, progression and quality of candidate's education, training and experience. The candidate's… more
    Sacramento County (10/22/24)
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  • Supervising Registered Nurse D/CF

    Sacramento County (Sacramento, CA)
    Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply  Supervising Registered Nurse ... at 5:00 pm on: 6/3/24, 8/5/24, 10/7/24, 12/2/24 Supervising Registered Nurse - Detention/Correctional Facility is the...Document Required with Application: All applicants MUST record their RN license type, number, and expiration date in the… more
    Sacramento County (10/22/24)
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