- Connecticut Children's (Hartford, CT)
- …-5% Escalates cases as appropriate for secondary review . -5% Performs concurrent and retrospective clinical reviews utilizing the appropriate guidelines as ... of level of care based on medical record documentation. -9% Gathers clinical information to conduct continued stay utilization review activities with… more
- Northwell Health (Great Neck, NY)
- … clinical documentation in the patient's medical record through a concurrent review process throughout the patient's inpatient stay. 4.Requests clarification ... of clinical documentation from the physician(s) on a ...date. *Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications… more
- Beth Israel Lahey Health (Plymouth, MA)
- …data to establish the appropriate level of care using Interqual criteria. Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal ... denials related to the care provided to the hospitalized patient. Conducts concurrent reviews to determine the continued need for acute care setting, appropriateness… more
- RIT Solutions, Inc. (New York, NY)
- Job Title: UM Nurse (California License) - Must be licensed in California- Remote Opportunity Work Hrs : (8am - 5pm PDT) would like to include evening, weekend and ... Remote Opportunity Ready to Hire ASAP. JD: The role of the UM Nurse is to promote quality, cost-effective outcomes for a population by facilitating collaboration… more
- UHS (Palmdale, CA)
- …and completeness of clinical documentation. Promotes a partnership between the concurrent clinical reviews, medical record coders, and physicians to improve ... Integrity Specialist. Duties include but not limited to: Providing clinically based concurrent and retrospective review of inpatient medical records to evaluate… more
- Northwell Health (New Hyde Park, NY)
- …Job Responsibility Facilitates patient management throughout hospitalization. Performs concurrent utilization management using evidence based medical necessity ... evaluating patient in collaboration with the health care team. Conducts chart review for appropriateness of admission and continued length of stay; Facilitates… more
- The Bear Creek School (Redmond, WA)
- …and new school nurse professionals in the role of school nurse . Quality Improvement Systemically review the quality-of-care delivery and recommend/initiate ... Job Description Job Title *: School Nurse Position Type : (Exempt or Non-Exempt): Non-exempt,...affecting student health. 2. Delivery of Health Services Utilize clinical reasoning and critical thinking skills to triage and… more
- University of Iowa Hospitals & Clinics (Iowa City, IA)
- …Healthcare Downtown Campus, is looking for a Nurse Clinician to functions as a clinical nurse expert and clinical coordinator acting as nurse liaison ... ensure that appropriate data are tracked, evaluated, and reported. Utilize an evidenced-based clinical review screening criteria as a guide to support medical… more
- Excela Health (Butler, PA)
- …monitoring. 7. Medical surgical overflow not requiring cardiac monitoring. 8. Patients with concurrent mental health needs. The Registered Nurse will support the ... provides acute nursing care to patients requiring telemetry monitoring. The Registered Nurse 's responsibilities include but are not limited to utilization of the… more
- Orlando Health (Clermont, FL)
- …Clermont, FL Status: Part-Time Department: Care Management Schedule: Days Title: Registered Nurse #LI-JM1 "Orlando Health Is Your Best Place to Work" is not ... to Work in Healthcare" by Modern Healthcare. A Care Manager Registered Nurse promotes and facilitates effective management of hospital resources from admission to… more
- UofL Health (Louisville, KY)
- …optimal management of clinical resources by conducting timely admission and concurrent utilization review for all patients of designated medical services; ... documents clinical information in Case Management Software system *During the concurrent review process, evaluates the medical record to identify any process… more
- Mary Washington Healthcare (Fredericksburg, VA)
- …at both State and National levels. Abstracts and organizes data obtained from concurrent and retrospective chart review of thoracic surgery patient subsets. ... Thoracic Surgery (STS) database. Performs outcomes analysis, identifies trends, initiates review and assists with coordination of MWHC quality improvement team… more
- UnitedHealth Group (Puyallup, WA)
- …as the link between patients and the appropriate health care personnel, the Clinical Review Coordinator- Onsite is responsible for ensuring efficient, smooth, ... of care Perform Skilled Nursing Facility (SNF) assessments on patients using clinical skills and utilizing CMS criteria upon admission to SNF and periodically… more
- PacificSource (Bend, OR)
- …needs for members engaged with care management, as well as the inpatient concurrent review process to ensure medical appropriateness, care coordination needs, ... Prior supervisory or management experience required. Education, Certificates, Licenses: Registered Nurse or Licensed Clinical Social Worker or other licensed… more
- Jaz Staffing Agency (Houston, TX)
- …needed. Uses quality screens to identify potential issues and forwards information to Clinical Quality Review Department. Ensures that all elements critical to ... with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost...Current and valid license to practice as a Registered Nurse in the state of Texas or Current and… more
- WMC Health (Valhalla, NY)
- …of 2 years of experience as a Trauma Performance Improvement Coordinator Education: Required Clinical Experience as a Nurse , Nurse Practitioner, or Physician ... and works closely with the Trauma Registry to ensure accurate concurrent data collection and identification of performance improvement occurrences. The Performance… more
- Kaiser Permanente (Atlanta, GA)
- …care by chart review and discussion with attending physician, admission and concurrent review for inpatient admissions, meetings with patient and families to ... care for hospitalized members by carrying out daily utilization and quality review , monitoring for inefficiencies and opportunities to improve care, developing a… more
- Advocate Aurora Health (Oak Lawn, IL)
- …UM activities as required based on local structure to include providing clinical updates to payers and/or external review organizations, collecting data, ... of care and transitions. Documents discharge planning interventions and utilization review activity per department and medical center standards in a timely… more
- Landmark Medical Center (Woonsocket, RI)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... accredited school of nursing and a current state Registered Nurse license Grandfathered prior to April 1, 2015. Minimum...of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. Five… more
- Orlando Health (Ocoee, FL)
- …areas. *Acts as an advocate for patient's health care needs. *Performs admission and concurrent utilization review in compliance with review requirements for ... contracts, governmental payors (ie Medicare, Medicaid, and Champus) and departmental review policies; adheres to Utilization Management Plan. *Communicates in an… more
