- RestoraCare Staffing (Houston, TX)
- RestoraCare Staffing is seeking a Registered Nurse ( RN ) Case Management for a nursing job in Houston, Texas.Job Description & RequirementsSpecialty: Case ... Licenses/Certifications: Current and valid license to practice as a Registered Nurse in the state of Texas...state of Texas required, LCSW preferred. Certification in Case Management required within two (2) years of hire into… more
- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials ... JOB DUTIES AND RESPONSIBILITIES: + Reviews all Inpatient Retroactive Denials in the Denials Management ...an accredited, professional nursing program. + Must have current RN license to practice in the state of Pennsylvania… more
- Catholic Health Initiatives (Omaha, NE)
- …role within the revenue cycle by providing clinical expertise in the denials management process. The Denials RN performs a root cause analysis of ... as assigned by the manager. **Qualifications** **Required:** + Minimumthree (3)yearsclinical experience as Registered Nurse ( RN ) required. + RN license… more
- Diversicare Healthcare Services & Diversicare Ther (Brentwood, TN)
- …of Denials and Appeals you will Develop, Implement and Maintain a Denials /Appeals Management program for all payer types. This will include creation and ... maintenances of tracking system for all ARDS/ Denials with full responsibility for following each claim through...1. Current Nursing License by state board of nursing ( RN preferred) or related Healthcare field 2. Experience in… more
- Alameda Health System (Oakland, CA)
- …completion of financial analyses including cost of care to reimbursement, denials management , and non-reimbursed services, promoting effective resource ... Director, Inpatient System Care Management + Oakland, CA + Highland General Hospital...Preferred Experience: N/A Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California… more
- UNC Health Care (Chapel Hill, NC)
- …Management . This role is responsible for the daily operations of the Utilization Management and Clinical Denials Management functions of the department as ... unique communities we serve. Looking for a dynamic, seasoned ** RN with at least seven (7) years of Utilization/Case... with at least seven (7) years of Utilization/Case Management experience and at least two (2) years of… more
- Tufts Medicine (Burlington, MA)
- …**Job Description** **Minimum Qualifications:** 1. Bachelor's Degree in Nursing 2. Active Registered Nurse ( RN ) license in Massachusetts or compact ... setting (ICU, ED, Critical Care, strong Med/Surg Specialty) or equivalent case management , utilization review, denials management , or progressive leadership… more
- Houston Methodist (Baytown, TX)
- …HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or ... of opportunities for appropriate utilization of resources to avoid denials and resource management as it pertains...Compact State Licensure within 90 days or + RN -Temp - Registered Nurse -… more
- AdventHealth (Tampa, FL)
- …Center. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing ... through accordingly to prevent loss of reimbursement, including the management of concurrent and pre-bill denials . ..... Current and valid license to practice as a Registered Nurse (ADN or BSN) required. .… more
- AdventHealth (Hinsdale, IL)
- …resolution skills . Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** . State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- AdventHealth (Hinsdale, IL)
- …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- AdventHealth (Ocala, FL)
- …need to succeed** **:** **REQUIRED:** EDUCATION AND EXPERIENCE REQUIRED: * Associates Degree Nursing or RN Diploma degree * Registered Nurse ( RN ) * Two ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- AdventHealth (Orlando, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- Geisinger (Bloomsburg, PA)
- …and License(s) Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... of care using predetermined criteria, reporting potential risk and quality management issues identified from medical record review to appropriate departments through… more
- Trinity Health (Farmington Hills, MI)
- …professional behavior. **MINIMUM QUALIFICATIONS** Must possess a demonstrated knowledge of denial management functions. Registered Nurse and a graduate of ... Work Remote Position (Pay Range: $34.9314-$52.3971) Responsible for reviewing all post-billed denials (inclusive of clinical denials ) for medical necessity and… more
- Ascension Health (Pensacola, FL)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Florida Board of Nursing ... obtained prior to hire dateor job transfer date required. Licensed as a Registered Nurse in Florida required. Credentialed from State Board ofNursing or current… more
- Ascension Health (Wichita, KS)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing ... specifics._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning and utilization review. + Review admissions… more
- Bon Secours Mercy Health (Boardman, OH)
- …operational excellence. **Summary of Primary Function/General Purpose of Position** The RN Outpatient Wound Care performs and documents complete patient assessments, ... including scheduling, registration, clinical coverage/treatment, documentation, billing, collections, and denials . * Assists leadership to perform auditing to ensure… more
- Tenet Healthcare (Detroit, MI)
- …Nursing, Business Administration or Hospital Administration preferred. 2. Licensed to practice as a Registered Nurse in the State of Michigan; 3. Three to five ... “peer to peer” review process with payers to resolve denials or downgrades concurrently. Transition Management ·...Hospital Administration preferred. 2. Licensed to practice as a Registered Nurse in the State of Michigan;… more
- Ascension Health (Birmingham, AL)
- …Specialists obtained prior to hire date or job transfer date required. + Registered Nurse credentialed from the Alabama Board of Nursing obtained prior ... **Details** + **Department:** Case Management + **Schedule:** Monday-Friday, 4 10s or 5...following qualities: 4-5 years of CDI experience CCDS certification Denials experience NCD/LCD Denial prevention Strong knowledge in HACs/PSI… more
