- Centene Corporation (Jefferson City, MO)
- …providers, as appropriate, for any discrepancies between prior authorization and concurrent review processes to ensure clinically appropriate determinations + ... on workplace flexibility. **Position Purpose:** Performs a clinical retrospective review and assessment of complex services previously provided to determine… 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 ... 40 hours weekly; Dayshift; Monday through Friday. Candidates must hold a Registered Nurse license in Pennsylvania or a Multistate License. A minimum of 3 years… more
- Centene Corporation (Jefferson City, MO)
- …providers, as appropriate, for any discrepancies between prior authorization and concurrent review processes to ensure clinically appropriate determinations + ... quality of care issues, and if identified, refer to the Medical Director or provider for review and verification + Consults with senior management and healthcare… more
- Sacramento County (Sacramento, CA)
- …Employment Qualifications Minimum Qualifications Either: One year of experience as a Senior Public Health Nurse in Sacramento County service. Or: Two ... improperly rejected may request the Employment Services Division to review its decision to reject the application. If the...+ I have one year of experience as a Senior Public Health Nurse in Sacramento County… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Senior Clinical Risk Manager serves as a resource to staff to enhance patient safety, promote patient safety, quality of care, and minimize ... loss to protect the assets of the facility. The Senior Risk Manager supports the Risk Management staff on...supports the Risk Management staff on how best to review risk management data, conduct Root Cause Analysis, and… more
- Geisinger (Danville, PA)
- …PI Program and Trauma Registry. + Maintains trauma roster and updates on concurrent basis. + Summarizes concurrent daily chart rounding information into monthly ... quality improvement report and forwards initial review to leadership for secondary review and...of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE &… more
- Sacramento County (Sacramento, CA)
- Senior Mental Health Worker-Licensed Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/1036656) Apply Senior Mental Health Worker-Licensed ... plans with little direct supervision; provide direction to and review the work of assigned staff. + Establish and...the State of California to practice as a Registered Nurse , Vocational Nurse or Psychiatric Technician AND… more
- Kaleida Health (Buffalo, NY)
- …team, Nursing, Patient Management, Quality Department and ancillary staff to perform concurrent analytical review of clinical documentation and coding data. ... ** Senior Clinical Doc Specialist** **Location:** Larkin Bldg @...of the health care team. Also responsible for audit review to identify potential documentation deficiencies in specific records… more
- HCA Healthcare (El Paso, TX)
- …medical services and discharge planning for a specified patient population. Performs concurrent and retrospective review of patient medical records for purposes ... future of nursing." Sammie Mosier, DHA, MA, BSN, NE-BC Senior Vice President and Chief Nursing Executive, HCA Healthcare...path, we encourage you to apply for our Registered Nurse Case Manager opening. We review all… more
- Geisinger (Scranton, PA)
- …National Healthcare Safety Network (NHSN) reporting criteria and requirements. + Performs concurrent and retrospective medical record review including review ... Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review , we're working to create a national model for...and DOH surveys. At least 2 years of Registered Nurse work experience in a hospital setting is required.… 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 ... DRG assignment, risk of mortality, severity of illness; and initiate documentation of the review . + Pursues a subsequent review of records every 3 days to… more
- Geisinger (Scranton, PA)
- …As one of the Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review , we're working to create a national model for improving health. Today, we're ... reporting potential risk and quality management issues identified from medical record review to appropriate departments through defined processes, and enters data as… more
- Prime Healthcare (Riverdale, GA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... metro Atlanta communities. The hospital offers a complete line of services including Senior Care and Senior Behavioral Health Services; Emergency Services; Heart… more
- Oracle (Harrisburg, PA)
- …(ECD) alignments, Critical Care workflow implementation, Multi-Disciplinary Rounding, and various nurse chart review and documentation optimizations. The ideal ... and patient care improvements. Manage the nursing needs for multiple concurrent optimization projects, from requirements analysis and solution design to testing,… more
- BayCare Health System (Tampa, FL)
- …other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient ... of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior /RN responsibilities include:** + Functions as the… more
- Centene Corporation (Sacramento, CA)
- …a fresh perspective on workplace flexibility. **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical ... between utilization management team, members, and providers + Monitors prior authorization, concurrent review , and/or retrospective clinical review nurses… more
- Sharp HealthCare (Chula Vista, CA)
- …coding. Works closely with Case Management to redesign the process for concurrent review and authorization documentation. Consider technology alternatives and ... contract language that protect the hospital from concurrent review denials. + Collaborates with interdisciplinary teams including but not limited to Physicians, … more
- Sacramento County (Sacramento, CA)
- …clinic. OR: Two years of experience in the class of Mental Health Counselor, Psychiatric Nurse , Senior Mental Health Counselor, Senior Psychiatric Nurse , ... Licensed Clinical Social Worker, Marriage and Family Therapist, or Registered Nurse . AND Either: Two years of experience coordinating and/or supervising mental… more
- HCA Healthcare (Kansas City, MO)
- …database to ensure adequate documentation as required by regulatory agencies. + Complete concurrent review of cases to identify quality, timelines and systems of ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...and Patient Safety (PIPS) Program. The PI Coordinator will review the continuum of care to determine compliance with… more
- Dignity Health (Sacramento, CA)
- …role also serves as a resource to employees, management, nursing directors, senior management, councils, physicians and teams on quality management activities and ... experience, efficiency, FMEAS, root cause analyses and medical staff improvement (eg case review for peer review , OPPE, FPPE). + Participates in an integral… more