's Registered Nurse (RN) license and at least two years of experience required" Comments for Vendors: Must live in Orange county... services Assist member with filing and resolving complaints and appeals Internal/External Groups with which the Candidate...
's Registered Nurse (RN) license and at least two years of experience required" Day to Day Responsibilities of this Position... with filing and resolving complaints and appeals. Bachelor's degree or Registered Nurse License and 2+ years of care...
Location/s: Main Campus Jackson Job Title: RN- Utilization Review Job Summary: Accountable to perform utilization... reviews by applying clinical protocols and review medical necessity criteria. Reports quality of care issues identified...
criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians... with Level I adult and Level II pediatric trauma designations. The advanced capabilities and clinical expertise...
of admission and continued stay clinical review, including obtaining insurance certification/authorization necessary to secure...-based clinical criteria and M Health Fairview guidelines to determine the appropriateness of level of care, length of stay...
in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives... Utilization Management RN provides feedback as requested to enhance negotiations with payers. Assesses for accuracy in the...
Summary: We have an exciting opportunity to join our team as a Care Manager (RN) - Evenings. In this role, the... utilization review of patients for appropriateness of setting using industry standard utilization clinical criteria including...
criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians... II pediatric trauma designations. The advanced capabilities and clinical expertise within this center have earned it...
GENERAL SUMMARY: The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial...: *Commits to the mission, vision, beliefs and consistently demonstrates our core values. *Utilizes clinical skills to create...
**$10,000 Sign On Bonus for offers accepted by March 31, 2025. Terms and Conditions apply** The RN Care Coordinator..., or Registration Requirements for continued employment: Current RN licensure in Virginia Complete 15 Continuing Education Units...
Minimum Qualifications: RN with Bachelor's degree in Nursing and two years of inpatient experience in a hospital... of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information...
, through coordination of patient care, daily clinical reviews, quality documentation, appeals, and reporting. QUALIFICATIONS... technicians, support staff and administration. We are currently seeking a forward thinking and compassionate RN, UTILIZATION...
, through coordination of patient care, daily clinical reviews, quality documentation, appeals, and reporting. QUALIFICATIONS... technicians, support staff and administration. We are currently seeking a forward thinking and compassionate RN, UTILIZATION...
Job Description: The RN Case Manager 1 provides discharge planning and continuity of care for assigned patients... and facilitation of precertification and payer authorization processes when indicated. Actively participates in clinical performance...
translational and clinical research that is driving a revolution in our understanding of cancer as a disease and improving the.... Job Description RN Case Manager, Inpatient | New York, NY Exciting Opportunity at MSK: Are you passionate about using your Case...
The Care Center RN is responsible for providing administrative services to patients, their families, and fellow.... The Care Center RN will provide professional nursing care to patients according to hospital policy and procedure...
Medication Refill, Prescription Denials Appeals, & overdue orders Manage staff members relative to clinical and patient care... of our vision to make healthcare better for everyone. At Optum, you’ll have the clinical resources, data and support of a global...
Medication Refill, Prescription Denials Appeals, & overdue orders Manage staff members relative to clinical and patient care... of our vision to make healthcare better for everyone. At Optum, you’ll have the clinical resources, data and support of a global...
NYS RN license required Experience: *Must have Current Clinical Hands on experience; with Care Management Experience... Education: Master's in Social Work, Business or Nursing - REQUIRED. License: Current NYS RN license required Current Clinical...
Job Description: The RN Case Manager 1 provides discharge planning and continuity of care for assigned patients... and facilitation of precertification and payer authorization processes when indicated. Actively participates in clinical performance...