- Actalent (Tigard, OR)
- Job Title: Clinical Review Nurse - Concurrent Review Work Environment + This is a 100% remote position + The schedule is Tuesday to Saturday, 10 AM to 7 ... management, and concurrent review . Job Description The Clinical Review Nurse will perform concurrent reviews to assess the member's overall health,… more
- Actalent (Tigard, OR)
- Job Title: Clinical Review Nurse - Concurrent Review (West Coast) Job Description We are seeking a dedicated Clinical Review Nurse to perform ... ensure care necessity and appropriate setting. + Prepare denial letters for concurrent review without member or provider outreach. + Work within TruCare Classic… more
- Actalent (Bakersfield, CA)
- Remote Concurrent Review Nurse Job Description We are seeking a dedicated Concurrent Review Nurse to perform concurrent reviews, assess ... based on diagnoses, prognoses, resources, and/or preferences + Manages and maintains concurrent review findings, discharge plans, and actions taken on member… more
- Centene Corporation (Sacramento, CA)
- …hold a current CA license **Must have** **5-7 years related** **experience in UM- Concurrent Review . 2+ years of acute care experience required. 10% Travel ... based on diagnoses, prognoses, resources, and/or preferences + Manages and maintains concurrent review findings, discharge plans, and actions taken on member… more
- Centene Corporation (Sacramento, CA)
- …hold a current CA license.** **Must have** **2-4 years related** **experience in UM- Concurrent Review . 2+ years of acute care experience required. 10% Travel ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
- RWJBarnabas Health (Jersey City, NJ)
- Nurse Midwife-PD Days-MMG Concurrent -Jersey City-NJReq #:0000192616 Category: Nurse Midwife Status:Per Diem Shift:Day Facility:Jersey City Medical Center ... Department:MMG Concurrent Pay Range:$94.76 per hour Location: 355 Grand Street,...355 Grand Street, Jersey CIty, NJ 07302 Job Title: Nurse Midwife Location: Jersey City Medical Center Department: MMG… more
- Beth Israel Lahey Health (Boston, MA)
- …being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for ... Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status based on… more
- CDPHP (Latham, NY)
- …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care reviews, post-acute care… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of children beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise, evidence-based guidelines, insurance ... authorization per contracts for medically appropriate level of care. Manages concurrent clinical denials through completion of verbal reconsideration process. Works… more
- UNC Health Care (Kinston, NC)
- …assures timely movement of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of ... the right place at the right time. To accomplish these goals, the UR, Nurse applies established criteria to evaluate the appropriateness of admission, level of care,… more
- HonorHealth (AZ)
- …Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care services ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- AdventHealth (Ocala, FL)
- …the team:** + Assures compliance with professional practice evaluation through concurrent and retrospective review , identification of deficiencies, and ... Practice Evaluation is responsible for facilitating the medical staff Peer Review , Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice… more
- Beth Israel Lahey Health (Plymouth, MA)
- …using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal clinical denials related to the care provided to ... the hospitalized patient. + Conducts concurrent reviews to determine the continued need for acute care setting, appropriateness and timeliness of… more
- Beth Israel Lahey Health (Cambridge, MA)
- …reliability processes to reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts, interpret ... Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported...to collect data for reporting quality measures, including both concurrent medical record review and periodic medical… more
- HCA Healthcare (Portsmouth, NH)
- …to you, we encourage you to apply for our Patient Safety Coordinator Registered Nurse opening. Our team will promptly review your application. Highly qualified ... in their positions. Join our Team as a Patient Safety Coordinator Registered Nurse and access programs to assist with every stage of your career. **Benefits**… more
- Baystate Health (Springfield, MA)
- …Center (BMC), a Magnet Hospital for Nursing Excellence is looking for a** ** Nurse Educator** **to join our** **Cardiac Cath and Electrophysiology Lab!** **The ... Nurse Educator, utilizes innovative and flexible solutions** **_(including leveraging...advancement of clinical nursing practice and professional development through review , critique, and dissemination of relevant current literature, research… more
- UHS (Johnson City, NY)
- Position OverviewThe Trauma Resource Nurse (TRN) has responsibility for concurrent trauma performance improvement and patient safety activities for the Trauma ... by working closely with the TPM and Trauma Registrars to assure accurate, concurrent clinical data abstraction and entry into the trauma registry. The TRN maintains… more
- Northwell Health (Lake Success, NY)
- …to clarify clinical documentation in the patient's medical record through a concurrent review process throughout the patient's inpatient stay. 4.Requests ... expected risk of mortality, and complexity of care provided. Responsible for concurrent inpatient medical record reviews for Medicare, Medicaid and all commercial… more
- ERP International (Barksdale AFB, LA)
- …including identification of types ofhealthcare services for which preauthorization or concurrent review will be required.Reviews previous and present medical ... **Overview** ERP International is seeking a **Utilization Management Registered Nurse (RN)** for a full-time position supporting the 2d Medical Group, Barksdale AFB,… more
- Alameda Health System (Oakland, CA)
- …utilization review functions, including response to payor requests for concurrent and retrospective review information including Medicare and MediCal ... Nurse , Care Management + Oakland, CA + Highland...physician, and the Care Management physician advisor of any concurrent denials. + Prepares case reports; documents treatment plan,… more