- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical ...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... clinical information and may also provide education on the medical review process. + The Contractor performing...be required to stand, bend and reach from open medical record shelving. + Licensure: Current, full,… more
- Ventura County (Ventura, CA)
- Per Diem Registered Nurse III - Hospital Case Management/Utilization Review Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4396275) Apply ... Per Diem Registered Nurse III - Hospital Case Management/Utilization Review Salary $119,061.54 - $151,803.47 Annually Location Ventura, CA Job Type Per-Diem Job… more
- Martin's Point Health Care (Portland, ME)
- …policies, and internal guidelines for medical necessity reviews. + Manage the review of medical claims disputes, records , and authorizations for billing, ... 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 ) for medical… 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 ... This includes approval determinations and appropriate exceptions, coordinating with Medical Directors on denials, completing inpatient level of care reviews,… more
- Elevance Health (Harrisburg, PA)
- …send you a check, or ask you for payment as part of consideration for employment. **Clinical Review Nurse I (US)** + Job Family: MED > Licensed Nurse + Type: ... + Maine, South Portland + Wisconsin, Waukesha **Description** **Clinical Review Nurse I** National Government Services is...medical coding is a plus. + Experience reviewing medical records ; and making decisions based on… more
- Beth Israel Lahey Health (Burlington, MA)
- …Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for admission and ... to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid...Possesses mid to high-level proficiency in navigating the Electronic Medical Record and applications related to utilization… more
- R1 RCM (Boise, ID)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Utilization Review Nurse ** , you will help our hospital clients by ... **Here's what you will experience working as a Utilization Review Nurse :** + Perform initial admission and...of care. + Abstract data from a variety of medical records to ensure accurate clinical data.… more
- Bassett Healthcare (Oneonta, NY)
- …information re: disease, treatment regimen, supportive care, etc. as documented in the medical record . The Registered Nurse counsels patients for treatment ... review and/or direct supervisory observation. The Registered Nurse implements and records interventions appropriate to...clinic visits as documented in the medical record as measured by random supervisory chart review… more
- InnovaCare (San Juan, PR)
- …to the business. MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the inpatient utilization ... visits to Acute, SNF, and Rehabilitation Inpatient facilities to concurrently review admissions and continued stay to determine appropriate Utilization, Quality… more
- Centene Corporation (Austin, TX)
- …concurrent review findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- Ascension Health (Pensacola, FL)
- …cases. + Assist departmental staff with issues related to coding, medical records /documentation, precertification, reimbursement and claim denials/appeals. + ... health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within assigned… more
- Centene Corporation (Sacramento, CA)
- …concurrent review findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management ... with interdepartmental teams on projects within utilization management as part of the clinical review team + Partners and works with Medical Affairs and/or … more
- Ascension Health (Wichita, KS)
- …cases. + Assist departmental staff with issues related to coding, medical records /documentation, precertification, reimbursement and claim denials/appeals. + ... **Details** + **Department:** Utilization Review - Behavior Health + **Schedule:** PRN, Day Shift, 8 hr shift, Rotating Weekends and Holidays + **Hospital:**… more
- Bassett Healthcare (Cooperstown, NY)
- …discuss specific positions in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Medical Inpatient units is accountable ... no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation Implements and records interventions… more
- Ascension Health (Southfield, MI)
- …cases. + Assist departmental staff with issues related to coding, medical records /documentation, precertification, reimbursement and claim denials/appeals. + ... health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within assigned… more
- Universal Health Services (Temecula, CA)
- …necessity of level of care and hospitalization for multiple entities. + Reviews medical record for presence of accurate placement orders reconciles variances ... care hospitals and several non-hospital access points, including: Corona Regional Medical Center, Palmdale Regional Medical Center, Southwest Healthcare Rancho… more
- Ventura County (Ventura, CA)
- …and medicines and narcotics. Working knowledge and proficiency with electronic medical records ("EMR") systems. Skill in: effective leadership, problem ... Per Diem Registered Nurse III - Ventura County Medical ...orders concerning treatments and medications; + Makes patient observations, records and reports all pertinent information; provides follow-through on… more
- CDPHP (Albany, NY)
- …these values and invites you to be a part of that experience. The Clinical Review and Coding Nurse is responsible to attain procedure and diagnosis coding ... The RN will also research new technology or services and recommend updates to medical policies. QUALIFICATIONS: + Associates degree required. + RN with a valid New… more
- Vighter Medical Group (Miami, FL)
- …Operating Procedures and protocols. + Maintains patient confidentiality and privacy of medical records , complies with HIPAA regulations as applicable, performs ... Nurse Practitioner Job Details Job Location Miami, FL...for any crime other than a minor traffic violation,the record of which has not been expunged. + Current… more