- UC Health (Cincinnati, OH)
- …Full Time 40 hr/week Shift: First UC Health is hiring a Full Time Registered Nurse ( RN ) for the Denials -Charge Audits for the first shift. This is a ... remote position. About University of Cincinnati Medical Center As part of the Clifton Campus of UC Health, Greater Cincinnati's academic health system, University of Cincinnati Medical Center has served Greater Cincinnati and Northern Kentucky for nearly 200… more
- Houston Behavioral Healthcare Hospital (Houston, TX)
- …safety. Houston Behavioral Healthcare Hospital is currently recruiting for full-time Intake Registered Nurse , 12hr shifts including alternating weekends. The MOT ... Intake Registered Nurse is primarily responsible managing the...Intake Registered Nurse is primarily responsible managing the MOT process The...for admission. + Notifies Director of Intake of any denials of admissions + The RN must… more
- AdventHealth (Hinsdale, IL)
- …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- AdventHealth (Orlando, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... Annual number of emergency cases: 89,018 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses,… more
- Ascension Health (Manhattan, KS)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing ... related to coding, medical records/documentation, precertification, reimbursement and claim denials /appeals. + Assess and coordinate discharge planning needs with… more
- AdventHealth (Tampa, FL)
- …Center. **The rol** **e you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing ... admission, treatment, and appropriate level of care. The UM RN leverages the algorithmic logic of the XSOLIS Cortex.... Current and valid license to practice as a Registered Nurse (ADN or BSN) required. .… more
- Beth Israel Lahey Health (Beverly, MA)
- …taking a job, you're making a difference in people's lives.** Case Manager RN **Job Description:** **Case Manager RN ** **Position Summary:** Case managers serve ... and retrospective review to assure appropriate utilization, assessment, prevention of denials and coordination of discharge options. They are required to follow… more
- Children's Mercy Kansas City (Kansas City, MO)
- …or demonstrated leadership skills in a previous role. One of the following: + Licensed RN - MO, Registered Nurse Multistate License Missouri required upon ... walls of our hospital. Overview The BSN, Admission and Denials Care Manager utilizes clinical expertise, insurance knowledge, business...hire + Licensed RN - Kansas, Registered Nurse … more
- Dartmouth Health (Lebanon, NH)
- …leadership, communication and computer skills desired. Required Licensure/Certifications - Licensed Registered Nurse with NH eligibility - Basic Life Support ... with pre-certifications. * Assumes responsibility for the oversight of inpatient denials , including, but not limited to, reviewing denial letters, collaborating with… more
- Trinity Health (Farmington Hills, MI)
- …**MINIMUM QUALIFICATIONS** Must possess a demonstrated knowledge of denial management functions. Registered Nurse and a graduate of an accredited school of ... Work Remote Position (Pay Range: $34.9314-$52.3971) Responsible for reviewing all post-billed denials (inclusive of clinical denials ) for medical necessity and… more
- Indian Health Service (Gallup, NM)
- …Clinical Director to resolve complex medical documentation problems. Utilizes Registered Nurse Training and expertise to prevent denials by instructing and ... Center in Gallup, NM. The purpose is to serve as the Nurse (Utilization Review) responsible for planning, organizing, implementing, & evaluating the functions… more
- Penn Medicine (Plainsboro, NJ)
- …reimbursement, proactively identify potential denials in order to avoid non-appealable denials ; Credentials: + Registered Nurse - NJ (Required) + ... Certified Case Manager (Required) + National Case Management certification preferred; or obtained within two years of employment. Education or Equivalent Experience: + Bachelor of Arts or Science (Required) + BSN degree requiredMinimum of 3 years… more
- Stanford Health Care (Palo Alto, CA)
- …**This is an onsite Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN ) will be responsible for ensuring the ... health record (EHR) systems and other healthcare software. **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact… more
- AdventHealth (Orlando, FL)
- …holistic environment. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by ... admission, treatment, and appropriate level of care. The UM RN leverages the algorithmic logic of the XSOLIS Cortex...and valid license to practice in Florida as a Registered Nurse (ADN or BSN) required. +… more
- Sharp HealthCare (San Diego, CA)
- …Certification; Accredited Case Manager (ACM) - American Case Management Association (ACMA); California Registered Nurse ( RN ) - CA Board of Registered ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...organization goals including reductions in length of stay, decreasing denials , improvement of care transitions, and reduction in avoidable… more
- Cleveland Clinic (Weston, FL)
- …as assigned. **Education:** *Graduate of an accredited school of nursing with licensure as a Registered Nurse ( RN ) in the State of Florida. *Bachelor of ... to the payer, UM data collection and reporting, concurrent denials appeals process, clinical team interaction, Physician Adviser interaction,...valid license in the State of Florida as a Registered Nurse ( RN ). *Basic Life… more
- Billings Clinic (Billings, MT)
- …Licenses * Healthcare Provider CPR Certification At hire * Current Montana license as a Registered Nurse At hire * Current working knowledge of payer and managed ... prior to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! RN - Utilization Review (Full-time/Billings) CARE MANAGEMENT (Billings Clinic… more
- Hartford HealthCare (Southington, CT)
- …concisely. **Maintains a flexible schedule to meet the needs of the agency. Licensure: Registered Nurse with a license to practice in the State ofConnecticut ... be spent in the following activities: **Monitor Advanced Beneficiary Notices and denials as it relates to medical necessity requirements. **Identify and evaluate … more
- UCHealth (Denver, CO)
- …/Professional Nursing program if less than 3 years experience. + CO State licensure as a Registered Nurse ( RN ). + 3 years of clinical experience as a ... Responsibilities: + Writes clinical appeals to payors to recover denials . Coordinates with payors to conduct RN reviews and facilitates MD to MD peer reviews as… more
- Houston Methodist (Nassau Bay, TX)
- At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse ( RN ) who comprehensively plans for case management of a target ... resource utilization, and continued stay. Reviews level of care denials to identify trends and collaborate with team to...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more