- Dignity Health (Woodland, CA)
- …Summary:** This position is responsible for monitoring Dignity Health Medical Foundation inpatient admissions and concurrent review for appropriate level ... - Clear and current CA RN license. **Preferred Qualifications:** - Concurrent review prior authorizations for medical determination, preferred. - Bachelors… more
- Dignity Health (Rancho Cordova, CA)
- …Summary:** This position is responsible for monitoring Dignity Health Medical Foundation inpatient admissions and concurrent review for appropriate level ... - Clear and current CA RN license. **Preferred Qualifications:** - Concurrent review , prior authorizations for medical determination preferred. - Bachelors… more
- Martin's Point Health Care (Portland, ME)
- …services, receives and reviews notification of emergent hospital admissions, completes inpatient concurrent review , establishes discharge plans, coordinates ... Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of...+ Review prior authorization requests (prior authorization, concurrent review , and retrospective review )… 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 ... for overall System Case Mix Index. Job Duties The RN CDI Specialist acts as a liaison between the...Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania… more
- Beth Israel Lahey Health (Boston, MA)
- …other related duties as required and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse ( RN ), Massachusetts + Three years of recent ... Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate...concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records… more
- Billings Clinic (Billings, MT)
- …- $40.07 (+ $2.25/hr Per Diem Differential) The Clinical Documentation Specialist - Inpatient will conduct concurrent review of clinical documentation in ... to all providers requirements and opportunities to all providers. Will conduct concurrent and retrospective medical record review for defined patient populations… more
- Geisinger (Scranton, PA)
- …providing direct support to inpatient hospital teams. Job Duties The Registered Nurse Care Manager works with physician and multidisciplinary team members ... Experience Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE… more
- Prime Healthcare (Inglewood, CA)
- …severity of illness. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A current California State Registered Nurse ( RN ) license is required. 2. Five years ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Connect With Us! (https://careers-primehealthcare.icims.com/jobs/227408/ registered - nurse %2c- rn… more
- Prime Healthcare (Inglewood, CA)
- …severity of illness. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A current California State Registered Nurse ( RN ) license is required. 2. Five years ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Connect With Us! (https://careers-primehealthcare.icims.com/jobs/224065/ registered - nurse %2c- rn… more
- Mayo Clinic (Rochester, MN)
- …teams. Major Functions of the RN Case Manager include: Utilization Review , including concurrent admission status and continued stay clinical review ... Government payers to meet managed care and continued stay requirements. The RN Case Manager participates with interdisciplinary, inpatient -hospital rounds and… more
- AdventHealth (Daytona Beach, FL)
- …Beach, 32117 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing ... RN is responsible for denial avoidance strategies including concurrent payer communications to resolve status disputes. The Utilization...+ Current and valid license to practice as a Registered Nurse (ADN or BSN) required. +… more
- Crouse Hospital (Syracuse, NY)
- …and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse ( RN ) to track and manage data and client ... Schedule: Full Time: 8:00am-4:30pm, requires 6 weekends a year. Utilization Management Registered Nurse ( RN ) Position Responsibilities: + Works… more
- HCA Healthcare (Austin, TX)
- …Associates Degree or higher level education . Bachelor's Degree in Nursing - preferred . Registered Nurse ( RN ) license in Texas. If Compact License, Texas ... colleagues in their positions. Join our Team as a(an) Registered Nurse Quality Coordinator and access programs...Stroke, STS, and CathPCI) . You will perform daily concurrent review and retrospective reviews as needed… more
- Centene Corporation (Oklahoma City, OK)
- …management processes preferred. **License/Certification:** + LPN - Licensed Practical Nurse or RN - Registered Nurse - OK State Licensure required Pay ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… 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...may reasonably be required._ **Education/Experience Required:** + Current MA RN licensure + Bachelor's Degree in Nursing or advanced… more
- Cognizant (Juneau, AK)
- …expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… 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
- Geisinger (Lewistown, PA)
- …Experience Minimum of 2 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE ... National Healthcare Safety Network (NHSN) reporting criteria and requirements. + Performs concurrent and retrospective medical record review including review … more
- Ansible Government Solutions (Memphis, TN)
- …our customers' success as if it is their own. Responsibilities + Act as the Registered Nurse Advisor for the facility's CDI program, focusing on both ... inpatient and outpatient services + Review health...(SNOMED-CT) consistent with ICD-10 CM code sets + Conduct concurrent or retrospective reviews of health records to clarify… more
- RWJBarnabas Health (Jersey City, NJ)
- …licensure as a Certified Nurse Midwife required; current New Jersey licensure as a Registered Nurse required. + BSN and MSN in nurse -midwifery from an ... Nurse Midwife-PD Days-MMG Concurrent -Jersey City-NJReq #:0000192616...Mid-level Practitioner Section; Department of OB/GYN. This role requires Inpatient and Outpatient coverage. Job Requirements: + Current New… more