- Fallon Health (Worcester, MA)
- …benefits or other related matters that are requested and the application of clinical criteria and medical necessity determinations. The Appeal Nurse is ... services. + Review member medical records, prior authorization documentation, and internal appeal decisions. + Ensure all relevant clinical and administrative… more
- St. Luke's University Health Network (Allentown, PA)
- …third party denials for medical necessity and tracks outcomes regarding appeal process. Assists billing staff regarding outpatient denials for experimental, coding ... required time frames and logging of action eg no appeal , appeal level and final decision with...SENSORY REQUIREMENTS: Requires sitting for up to 4 hours per day, 2 hours at a time. Standing for… more
- Virtua Health (Pennsauken, NJ)
- …- 6991 North Park Dr. Remote Type: On-Site Employment Type: Employee Employment Classification: Per Diem Time Type: Part time Work Shift: 1st Shift (United ... States of America) Total Weekly Hours: 0 Additional Locations: Job Information: Schedule: Per Diem Requirement: + 2 shifts per month. + Day before or after… more
- Sharp HealthCare (La Mesa, CA)
- **Facility:** Grossmont Hospital **City** La Mesa **Department** **Job Status** Per Diem **Shift** Day **FTE** 0 **Shift Start Time** **Shift End Time** ... care areas. This position requires the ability to combine clinical /quality considerations with regulatory/financial/utilization review demands to assure patients are… more
- Rochester Regional Health (Rochester, NY)
- …Case Management Location: Canton-Potsdam Hospital with floating to other hospital locations Hours Per Week: Per Diem Schedule: 8-hour variable shifts, ... service by modeling the Brand Promise and Core Values.RESPONSIBILITIES: + Conducts clinical reviews utilizing objective criteria (Interqual) to assign patient to the… more
- Mount Sinai Health System (Long Island City, NY)
- **Job Description** **Care Manager-Care Management- Per Diem -Day-Mount Sinai Queens** Responsible for coordinating the care of the patients across the continuum. ... Ensuring and facilitating the achievement of quality, clinical and cost outcomes; Negotiating, procuring and coordinating services and resources needed by the… more
- Guthrie (Binghamton, NY)
- …responsibilities include performing a variety of concurrent and retrospective UM-related clinical reviews and revenue cycle functions ensuring appropriate status and ... the UM program. Experience Bachelors in Nursing with a minimum of five years clinical experience in an acute health care setting preferred. RN with a minimum of… more
- HonorHealth (AZ)
- …urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, ... payers, upon admission and concurrently throughout the admission. + Reviews clinical documentation and facilitates modifications (as needed) to ensure that… more
- AdventHealth (Minneola, FL)
- **All the benefits and perks you need for you and your family:** + PRN ( per diem ) team members may contribute to the Adventist HealthCare Retirement Plan (but ... based on geographical location. **Category:** Nursing **Organization:** AdventHealth Minneola **Schedule:** Per Diem **Shift:** 3 - Night **Req ID:** 25036602… more
- HCA Healthcare (Nashville, TN)
- …+ Familiar with Joint Commission, State and Federal standards/requirements, and DRG vs Per diem reimbursement models. + Knowledgeable about third party payer ... **Job Summary and Qualifications** The Medical Director serves as a clinical resource and consultant to hospitals by providing identification, facilitation, and… more
- Atlantic Health System (Florham Park, NJ)
- …cross-coverage at the main campus as needed and participation in on-call and per - diem coverage, as assigned by the Department Chair. About the location: ... adolescents with psychiatric needs referred from the Child and Adolescent clinical team, the Behavioral Health Assessment Center, Psychiatric Emergency Services, the… more
- AdventHealth (Minneola, FL)
- …on geographical location. **Category:** Rehabilitation Services **Organization:** AdventHealth Minneola **Schedule:** Per Diem **Shift:** 1 - Day **Req ID:** ... charm and friendly atmosphere makes this an exceptional destination. This community's appeal continues to grow as exciting new developments are underway near the… more
- AdventHealth (Minneola, FL)
- …based on geographical location. **Category:** Radiology/Imaging **Organization:** AdventHealth Minneola **Schedule:** Per Diem **Shift:** 1 - Day **Req ID:** ... charm and friendly atmosphere makes this an exceptional destination. This community's appeal continues to grow as exciting new developments are underway near the… more
- AdventHealth (Minneola, FL)
- …based on geographical location. **Category:** Radiology/Imaging **Organization:** AdventHealth Minneola **Schedule:** Per Diem **Shift:** 1 - Day **Req ID:** ... charm and friendly atmosphere makes this an exceptional destination. This community's appeal continues to grow as exciting new developments are underway near the… more
- AdventHealth (Minneola, FL)
- …based on geographical location. **Category:** Radiology/Imaging **Organization:** AdventHealth Minneola **Schedule:** Per Diem **Shift:** 1 - Day **Req ID:** ... charm and friendly atmosphere makes this an exceptional destination. This community's appeal continues to grow as exciting new developments are underway near the… more
- AdventHealth (Minneola, FL)
- …vary based on geographical location. **Category:** Surgery **Organization:** AdventHealth Minneola **Schedule:** Per Diem **Shift:** 1 - Day **Req ID:** 25022133 ... charm and friendly atmosphere makes this an exceptional destination. This community's appeal continues to grow as exciting new developments are underway near the… more