- 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 ... Inpatient within forty-eight (48) hours of having performed the first concurrent review of notified admission cases.4. On a daily basis, concurrently reviews… more
- Centene Corporation (Salem, OR)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- Centene Corporation (Sacramento, CA)
- …based on diagnoses, prognoses, resources, and/or preferences + Manages and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Provides education to providers on… more
- RWJBarnabas Health (Jersey City, NJ)
- Nurse Midwife(FT) Days- MMG Concurrent -Jersey CityReq #:0000106025 Category: Nurse Midwife Status:Full-Time Shift:Day Facility:Jersey City Medical Center ... Department:MMG Concurrent Location: Jersey City Medical Center, 355 Grand Street,...Street, Jersey CIty, NJ 07302 Job Overview- The Certified Nurse Midwife position provides antepartum, intrapartum, postpartum, neonatal and… more
- Kelsey-Seybold Clinic (Houston, TX)
- **Responsibilities** The Concurrent Review Case Manager is responsible for telephonic monitoring and the documentation of medical treatment and comparing it to ... criteria to determine if treatment meets established guidelines. In addition, the Concurrent Review Case Manager monitors patients progress toward recovery for… more
- Sharp HealthCare (San Diego, CA)
- …Medical-Surgical Nursing, and/or Home Health. + 1 Year Utilization Management/ Concurrent review experience. + California Registered Nurse (RN) - CA Board of ... **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree in Nursing… more
- Robert Half Office Team (Monterey Park, CA)
- …any inpatient setting * May performs telephonic and/or on-site admission and concurrent review , and collaborates with onsite staff, physicians, providers, ... Description The Utilization Management Nurse Specialist LVN promotes the quality and cost...Director and Medical Director on case reviews for pre-service, concurrent , post-service, retrospective claims medical review , and… more
- Beth Israel Lahey Health (Burlington, MA)
- …being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for ... is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three payments. You… more
- CDPHP (Albany, 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 ... completing inpatient level of care reviews, post-acute care initial and concurrent reviews for acute and subacute rehabilitation, transportation and DME requests.… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of the Utilization Review Team and ... clinical review prior to payment. The Utilization Review Nurse will use appropriate governmental policies...also review prior authorization requests (prior authorization, concurrent review , and retrospective review )… more
- Glens Falls Hospital (Glens Falls, NY)
- …hours per week, can be foundhere. **Job:** **Nursing - Case Management* **Title:** *Registered Nurse - Utilization Review Nurse - Care Management (Sign-On ... * * *How You Will Fulfill Your Potential* *Responsibilities* * Conducts concurrent and retrospective review (s) utilizing InterQual (IQ) medical necessity… more
- Actalent (Santa Rosa, CA)
- …the monitoring and evaluation of processes for clinical performance improvement and peer review . The Coordinator supports concurrent oversight and review of ... risk, high volume populations (eg, Stroke, diabetes, heart disease, etc.). Skills: Registered Nurse , Quality, Peer Review , Epic, Patient care Top Skills Details:… more
- University of Utah Health (Salt Lake City, UT)
- …continued stay review . + Communication to third-party payers for initial and concurrent clinical review . + Reviews patient chart to ensure patient continues ... cost, or over/under-utilization of resources. + Performs verbal/fax clinical review with payer as determined by nursing judgment and/or...Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one… more
- LA Care Health Plan (Los Angeles, CA)
- …in any inpatient setting. Performs telephonic and/or on site admission and concurrent review , and collaborates with onsite staff, physicians, providers, ... Utilization Management Nurse Specialist RN II Job Category: Clinical Department:...workplace environment. Perform telephonic and/or on site admission and concurrent review , and collaborates with onsite staff,… more
- HCA Healthcare (Las Vegas, NV)
- …clinical data compiled by hospital medical records for the purpose of admission/ concurrent review for Medicare and self-pay patients + Identifies potential ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...and apply today! + You will be performing admission review to determine appropriateness and medical necessity based on… more
- Insight Global (Bethesda, MD)
- Job Description An employer is searching for a Registered Nurse - Trauma at a major medical center in Bethesda, MD. This person must have strong knowledge of a wide ... Surgery (TACS) Program. This person will also ensure timely and accurate concurrent and retrospective reviews of trauma patients' (civilian and military) medical… more
- Rush University Medical Center (Chicago, IL)
- …the medical necessity, appropriateness, and quality of care. Applies criteria, performs concurrent review process. Works with physicians and Medical Director ... **Shift:** **Shift 1** **Work Schedule:** 8 Hr **Summary:** The Nurse Care Manager 1 works with physician practices and...regarding Case issues and concurrent denials an indicated. 6. Applies pathways/guidelines, assesses variances,… more
- ProgenyHealth (Elk Grove Village, IL)
- …Clinical care nurses coordinate overall member care, from pre-admission, continued stay ( concurrent review ) and any outpatient services utilizing a pro-active, ... attaining quality outcomes for the members. The clinical care nurse serves as a nurse reviewer for...Three or more years of experience working in a concurrent review or discharge planning role within… more
- Sacramento County (Sacramento, CA)
- Psychiatric Nurse Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/981663) Apply Psychiatric Nurse Salary $108,283.68 - $119,370.96 ... Note: For additional nursing opportunities please see Registered Nurse DCF Level I/II (https://www.governmentjobs.com/careers/sacramento/jobs/454059/registered- nurse -dcf-level-i-ii?keywords=registered%20nurse&pagetype=jobOpportunitiesJobs) ,… more
- Sacramento County (Sacramento, CA)
- Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply Supervising Registered Nurse D/CF Salary ... 5:00 pm on: 2/5/24, 4/2/24, 6/3/24, 8/5/24, 10/7/24, 12/2/24 Supervising Registered Nurse - Detention/Correctional Facility is the first level supervisory class in… more
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