with other departments, i.e.: Pre-Admissions, Admissions, Patient Accounts, Utilization Review, PPS Coordinator, etc., to assure positive... / Los Angeles, CA Case Manager (CM) - Full Time (on-site) Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW) Pay...
utilization review/appeals background Benefits of the Registered Nurse Clinical Reviewer: The salary for this position is $55... experience in a medical review setting Greenlife Healthcare Staffing is currently seeking a Registered Nurse Clinical Reviewer...
by supervisor. Participates in Utilization Review/Quality Assurance/Continuous Quality Improvement activities based on organization... is looking for a Psychiatric Nurse Practitioner or Physician Assistant committed to providing high-quality outpatient primary care at our Brookside...
by supervisor. Participates in Utilization Review/Quality Assurance/Continuous Quality Improvement activities based on organization... is looking for a Psychiatric Nurse Practitioner or Psychiatric Physician Assistant committed to providing high-quality outpatient primary care...
, appropriateness, and efficiency of the use of health care services, procedures, and facilities for utilization review... familiarity with the Internet, Word and Excel. PREFERRED SKILLS B.S.N. Preferred Minimum two years utilization review...
preferred, however will also consider Utilization Review, Managed Care, Case Management experience 2-5 years in either Medical...Position Summary . We are seeking a registered nurse with extensive experience in clinical auditing to perform a bill...
Job Description: Up to $10,000 Sign-On bonus based on experience Summary Responsible for utilization review... and appeals. Tracking and reporting of data for other departments. Qualifications EDUCATION Graduate of Registered Nurse...
including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization.... Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD). Conducts...
including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization... Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD) Conducts...
including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization.... Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD). Conducts...
including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization.... Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD). Conducts...
including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization.... Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD). Conducts...
requirements related to care management and utilization review. Develop and foster effective collaboration between Case... for utilization review and management activities Coordinate all UM Committee activities to ensure compliance with meeting frequency...
including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization.... Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD). Conducts...
including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization... Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD) Conducts...
role. Understands and support the Medicare workflows related to denial review and appeals management, including the... and will be responsible for review and interpretation of current medical policies for systematization. Must be able to translate written...
) Operations Medical reimbursement and policy Care management (utilization management, case management, PA, appeals... and medical necessity of healthcare services provided to Plan members Conducts retrospective reviews of claims and appeals...
utilization review of patients for appropriateness of setting using industry standard utilization clinical criteria including... Review Instrument PRI Assessor 3 5 years Discharge planning and/or utilization management Knowledge of post acute care...
, overseeing facilities maintenance and service contracts, and conducting assessments of equipment and space utilization and needs.... Apply specialized knowledge to review medical documentation to assure proper coding for highly technical Gamma Knife procedures. Develop...
's Degree preferred. Minimum Experience: Two years related in acute care facility and/or utilization review training... as a Registered Nurse in the State of California. Additional Information Note: Home Health experience and Util. Review. highly...