• Clinical Review Nurse

    Centene Corporation (Jefferson City, MO)
    …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 (05/30/25)
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  • RN - Clinical Documentation Specialist,…

    SSM Health (MO)
    …Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin.** **Job Summary:** Performs concurrent analytical reviews of clinical and coding data to ... Type:** Regular **Job Highlights:** Must have prior and direct Clinical Documentation experience **Preferred Qualifications:** + CCDS certification + Proficiency… more
    SSM Health (06/03/25)
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  • Clinical Documentation Specialist, Second…

    SSM Health (MO)
    …provides feedback to clinical staff regarding these requirements during the concurrent record review process. + Maintains knowledge of mortality models, ... Type:** Regular **Job Highlights:** Must have prior and direct Clinical Documentation experience **Preferred Qualifications:** + CCDS certification + Proficiency… more
    SSM Health (03/19/25)
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  • Utilization Review Clinician - BH

    Centene Corporation (Jefferson City, MO)
    …EXPERIENCE OR HAVE WASHINGTON STATE BEHAVIORAL HEALTH LICENSURE **Position Purpose:** Performs a clinical review and assesses care related to mental health and ... medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine… more
    Centene Corporation (05/24/25)
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  • Supervisor, Utilization Management

    Centene Corporation (Jefferson City, MO)
    …**_ Remote Role _** **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical Review team ... between utilization management team, members, and providers + Monitors prior authorization, concurrent review , and/or retrospective clinical review more
    Centene Corporation (05/31/25)
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  • RN Trauma Performance Improvement Coordinator

    HCA Healthcare (Independence, MO)
    …database to ensure adequate documentation as required by regulatory agencies. + Complete concurrent review of cases to identify quality, timelines and systems of ... and Patient Safety (PIPS) Program. The PI Coordinator will review the continuum of care to determine compliance with...trauma patients. + Serve as a liaison to the clinical areas responsible for trauma patients. + Coordinate multidisciplinary… more
    HCA Healthcare (06/05/25)
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