for a specified patient population. Performs concurrent and retrospective review of patient medical records for purposes.../process/role, needs assessment, principles of utilization review/quality assurance, use of InterQual® or other clinical...
for a specified patient population. Performs concurrent and retrospective review of patient medical records for purposes.../process/role, needs assessment, principles of utilization review/quality assurance, use of InterQual® or other clinical...
for a specified patient population. Performs concurrent and retrospective review of patient medical records for purposes.../process/role, needs assessment, principles of utilization review/quality assurance, use of InterQual® or other clinical...
for a specified patient population. Performs concurrent and retrospective review of patient medical records for purposes.../process/role, needs assessment, principles of utilization review/quality assurance, use of InterQual® or other clinical...
function in this role is to Performs admission and concurrent review for all payers and maintains legible documentation... you to apply for our Case Manager Registered Nurse RN PRN opening. We review all applications. Qualified candidates will be contacted...
review. General Medical-Surgical nursing is sufficient to be relevant to the clinical areas addressed in most initial... and concurrent review within the guidelines of URAC, disability, workers compensation regulations, and state and federal requirements...
delivered Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical... providers to approve medical determinations or provide recommendations based on requested services and concurrent review...
delivered Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical... providers to approve medical determinations or provide recommendations based on requested services and concurrent review...
and/or Medical Directors as needed to discuss member care being delivered Collects, documents, and maintains concurrent review... based on requested services and concurrent review findings Assists with providing education to providers on utilization...
Medical Management - Concurrent Review Nurse- RN 145-2009 Tulsa, OK, USA Req #710 Friday, December 13, 2024... JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination...
and/or procedures providing prior authorizations and/or concurrent review. Mentors and trains new team members. Assesses services... and/or concurrent review. This position also trains and mentors new team members as well as assesses services for Sendero members...
position to all audiences Performs other duties as assigned Position: UM Outpatient Clinical Review Nurse /Utilization... level of care, using applicable coverage documents and clinical guidelines Collects, documents, and maintains review...
Clinical Review Coordinator is responsible for concurrent review for post-acute levels of care. Review clinical documents... * from anywhere within the U.S. as you take on some tough challenges Primary Responsibilities: Request and review member’s clinical...
and provide coverage for the Appeals & Grievances in Clinical Claims Review. You’ll enjoy the flexibility to work remotely... requirements Ensure that all necessary clinical information is available to allow for a full and fair review Outreach...
Scheduled Bi-Weekly Hours 0 Work Shift Day: 8 hours Job Description The Clinical Utilization Review and Appeals... Coordinator combines clinical, business and regulatory knowledge and skill to reduce financial risk and exposure caused...
authorization and complete concurrent reviews Review the need for denial of stay with assigned clinical treatment team when patient... is required. Required to be knowledgeable of and follow the Nurse Practice Act Previous utilization review experience preferred Knowledge of UR Standards...
Engagement Description Perform prospective, concurrent, and retrospective review of inpatient, outpatient, ambulatory... as: Registered Nurse-Review Analyst:...
Our Client, a Health Insurance Company, is looking for Registered Nurse-Review Analyst for their Detroit, MI location... Responsibilities: Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary...
: Registered Nurse-Review Analys Work Location: Detroit, MI, 48243 Duration: 10 Months Job Type: Contract Work Type: Remote... Dept: NBU Medical Engagement Description: Perform prospective, concurrent and retrospective review of inpatient...
RN- Utilization Review Nurse Inpatient *Full Time - 100% Remote Opportunity* COME WORK FOR THE LEADING, LOCAL... MANAGED CARE COMPANY - VILLAGE CARE! VillageCare is looking for a self-motivated and passionate RN as Utilization Review...