- Centene Corporation (Nashville, TN)
- …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
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a CDI Concurrent Review and Query Specialist? At HCA Healthcare you come first. HCA Healthcare ... a difference. We are looking for a dedicated CDI Concurrent Review and Query Specialist like you...to physicians for conflicting, imprecise, incomplete, illegible, or inconsistent clinical documentation. This individual need to function in a… more
- Molina Healthcare (Bowling Green, KY)
- …requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care ... Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to the enterprise. Primary responsibilities will include… more
- Molina Healthcare (Bowling Green, KY)
- …requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care ... state, and local laws and regulatory requirements affecting the medical and clinical staff. **Job Duties** + Provides medical oversight and expertise in… more
- HCA Healthcare (Nashville, TN)
- …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 (Madison, TN)
- …As a member of our team: + You will be responsible for collecting clinical information relative to a transfer request, and then facilitates the transfer by matching ... the patient's clinical needs to the facility with bed capacity and...plan of care. + You will ensure accurate and concurrent data collection and maintenance in both Meditech and… more
- HCA Healthcare (Madison, TN)
- …As a member of our team: + You will be responsible for collecting clinical information relative to a transfer request, and then facilitates the transfer by matching ... the patient's clinical needs to the facility with bed capacity and...plan of care. + You will ensure accurate and concurrent data collection and maintenance in both Meditech and… more
- HCA Healthcare (Hermitage, TN)
- …medical staff to ensure understanding of metrics to achieve targeted results + Concurrent clinical rounding to ensure compliance with core measures and evidence ... Hospital and Administrative Team and Executive Team, regarding volumes, outcomes (Financial/ Clinical ) and markets program strategies. + Assists and participates in… more
- Ascension Health (Nashville, TN)
- …continuing education initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully ... Management to join our team! In this pivotal role, you'll lead clinical discussions during Payer JOC meetings, oversee denial management activities, and perform… more