- Actalent (St. Joseph, MO)
- …role involves documenting comprehensive patient evaluations from providers and maintaining accurate documentation . The nurse will review patient information ... and discuss outcomes with providers. This position requires collaboration with the nurse manager to create individualized care plans that prioritize patient comfort… more
- Geisinger (Danville, PA)
- …procedures for accurate DRG assignment, risk of mortality, severity of illness; and initiate documentation of the review . + Pursues a subsequent review of ... on site position located in Danville, Pennsylvania. The Clinical Documentation Improvement Program (CDI) is designed to improve the...highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to… more
- Geisinger (Danville, PA)
- …and procedures for accurate assignment, risk of mortality, severity of illness; and initiate documentation of the review . + Pursues a subsequent review of ... Job Summary The Clinical Documentation Improvement Program is designed to improve the...discharge. + Consistently meets established productivity targets for record review . + Identifies strategies for sustained work process changes… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE ... comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're… more
- Intermountain Health (Las Vegas, NV)
- **Job Description:** The Clinical Documentation Integrity Nurse (CDI RN) utilizes clinical expertise, expert coding knowledge, and critical thinking skills to ... and contracting, insurance regulations, and risk adjustment capitated revenue. Nurses review complex clinical provider notes and communicate with providers to… more
- Geisinger (Danville, PA)
- …annual department and individual performance goals for the upcoming year. Proactively review clinical documentation . + Initiates recommendations for changes in ... Job Summary The Clinical Documentation Improvement Program (CDI) is designed to improve...Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE &… more
- Northwell Health (Lake Success, NY)
- **Req Number** 157409 Job Description Facilitates and obtains appropriate clinical documentation for all clinical conditions or procedures to support the appropriate ... discussions with physicians for clarification of ambiguous or conflicting documentation . Job Responsibility 1.Facilitates clarification of clinical documentation … more
- Community Health Systems (Fort Wayne, IN)
- …queries. + Conducts follow-up reviews of patient records to identify new documentation opportunities and ensures accuracy through continuous review . + Tracks ... **Job Summary** The Clinical Documentation Specialist (CDS) performs clinical documentation ...corporate policies. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Utilization Review Services Registered Nurse ? At Parallon, you come first. HCA Healthcare has ... a difference. We are looking for a dedicated Utilization Review Services Registered Nurse like you to...in the application and use of InterQual + Analyze documentation of clinical care from the electronic medical record… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... concurrently determines the appropriateness of inpatient or observation services following review of relevant medical documentation , medical guidelines, and… more
- CDPHP (Albany, NY)
- …Utilization Review (UR) Nurse is responsible for the clinical review and documentation for services requiring prior authorization. This includes approval ... with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
- Medical Mutual of Ohio (OH)
- …pre-employment substance abuse and nicotine testing._ **Title:** _Clinical Appeal & Claim Review Nurse II_ **Location:** _Ohio_ **Requisition ID:** _2500127_ ... in clinical documentation improvement, medical coding or medical documentation investigation preferred. **Professional Certification(s):** + Registered Nurse … more
- US Tech Solutions (Chicago, IL)
- …with clinical policy, regulatory and accreditation guidelines. + Responsible for the review and evaluation of clinical information and documentation . + Reviews ... experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions is a global staff… more
- R1 RCM (Detroit, MI)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Utilization Review Nurse ** , you will help our hospital clients by ... case, you will ensure that appropriate orders and clinical documentation are in place prior to the application of...**Here's what you will experience working as a Utilization Review Nurse :** + Perform initial admission and… more
- AmeriHealth Caritas (Philadelphia, PA)
- …the hours or services requested and may ask for additional supporting documentation when needed. Additionally, based on clinical judgement the Clinical Care Reviewer ... may contact the home care agency for documentation of member interventions and goals. Following the shift...is presented to the Medical Director for medical necessity review . Upon approval of services, responsibilities include timely notification… more
- Ascension Health (Pensacola, FL)
- **Details** **Department: Utilization Review ** **Schedule: M-F 0800-1630 with rotating Holidays** **Hospital: Ascension Sacred Heart Pensacola** **Location: ... health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within assigned… more
- US Tech Solutions (May, OK)
- …with clinical policy, regulatory and accreditation guidelines. . Responsible for the review and evaluation of clinical information and documentation . . Reviews ... make recommendations to meet QM objectives Responsibilities: . Reviews documentation and evaluates Potential Quality of Care issues based.... 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior… more
- Actalent (Sunrise, FL)
- Actalent is hiring UM nurses!Job Description The Utilization Management Nurse (UMN) plays a crucial role in optimizing the utilization of healthcare services. ... internal process development, and educates physicians and team members on utilization review issues. Ensuring smooth transitions and patient satisfaction is key to… more
- UNC Health Care (Kinston, NC)
- …the right place at the right time. To accomplish these goals, the UR, Nurse applies established criteria to evaluate the appropriateness of admission, level of care, ... movement of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of care delays/issues as… more
- Community Health Systems (Naples, FL)
- **Job Summary** Under the direction of the UR Director/Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical condition ... improvement of the UR KPI's. Ensures proper and accurate medical record documentation . **Essential Functions** + Reviews new admissions using 3rd party product for… more
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