Position Summary: The Utilization Review Specialist/Outcomes Specialist conducts concurrent and retrospective review.... Education: Holds a current Texas license as a Registered Nurse. Training and Experience: Three years clinical nursing...
, coordination, and follow-up of all concurrent and retrospective inpatient clinical denials. The Denial Review Coordinator... Experience And Skills Speaks, reads and writes English 5 years of clinical nurse experience 2 years of Case Management...
and complete cases as identified on initial, concurrent and discharged review work queue. Monitor and complete cases on the Stop.... WHAT YOU CAN EXPECT Complete medical necessity review of charts. Communicate with insurance companies when indicated to provide...
and concurrent stay medical record review to determine appropriateness of admission, continued stay, and setting. Follows patient... Nurse currently licensed in the State of South Carolina Required Training: None. Essential Functions Works...
criteria. The Care Review Clinician will create authorizations, manage clinical reviews, and collaborate with medical directors... to determine if requests meet COC criteria or Community Support criteria. Provide concurrent review and prior authorizations...
for level of care within the review citing specific clinical information as necessary. Ensures physician order is appropriate... Clinical nursing experience (Required) Licenses and Certifications Registered Nurse (RN) - State Department of Health...
for review and determination. Gathers clinical information to conduct continued stay utilization review activities with payers... on a daily basis. Performs concurrent and retrospective clinical reviews with various payers, utilizing the appropriate...
and professional staff to obtain appropriate clinical documentation for review and optimal patient placement. Maintains contact...Broward Health Point Shift: Shift 1 FTE: 1.000000 Summary: Performs and monitors integrated, concurrent...
Responsibilities Designs and maintains an ongoing Utilization Review Program to monitor and evaluate the quality... and appropriateness of patient care. Assures that each department has a written plan for the Utilization Review Program and that these...
Overview: The Director of Utilization Review is accountable for managing the Utilization Review functions of the... supervises the Utilization Review Coordinators and Case Managers. This position has frequent contacts with Physicians, patients...
payers, Provides concurrent and retrospective reviews in an effort to extend authorized days and ensure reimbursement due... for services provided 2. Subject matter expert regarding clinical appropriateness and level of care for CIC staff as well...
request of third party payers, Provides concurrent and retrospective reviews in an effort to extend authorized days... and ensure reimbursement due for services provided 2. Subject matter expert regarding clinical appropriateness and level...
payers, Provides concurrent and retrospective reviews in an effort to extend authorized days and ensure reimbursement due... for services provided 2. Subject matter expert regarding clinical appropriateness and level of care for CIC staff as well...
payers, Provides concurrent and retrospective reviews in an effort to extend authorized days and ensure reimbursement due... for services provided 2. Subject matter expert regarding clinical appropriateness and level of care for CIC staff as well...
request of third party payers, Provides concurrent and retrospective reviews in an effort to extend authorized days... and ensure reimbursement due for services provided 2. Subject matter expert regarding clinical appropriateness and level...
payers, Provides concurrent and retrospective reviews in an effort to extend authorized days and ensure reimbursement due... for services provided 2. Subject matter expert regarding clinical appropriateness and level of care for CIC staff as well...
payers, Provides concurrent and retrospective reviews in an effort to extend authorized days and ensure reimbursement due... for services provided 2. Subject matter expert regarding clinical appropriateness and level of care for CIC staff as well...
payers, Provides concurrent and retrospective reviews in an effort to extend authorized days and ensure reimbursement due... for services provided 2. Subject matter expert regarding clinical appropriateness and level of care for CIC staff as well...
) Job Description Clinical Documentation Specialists provide concurrent review of the clinical documentation in the medical records. Provides... internal career site to complete your application! Clinical Documentation Specialist (Registered Nurse...
national and international levels. Job Summary The Clinical Research Nurse is a part of the Sleep Research Center in the..., sleep technicians, data managers and trainees. The Sleep Research Center conducts clinical research studies focusing on the...