decisions. By serving as the link between patients and the appropriate health care personnel, the Clinical Review Coordinator... using clinical skills and utilizing CMS criteria upon admission to SNF and periodically through the patient stays Review...
areas. This position requires the ability to combine clinical/quality considerations with regulatory/financial/utilization... review demands to assure patients are receiving care in the appropriate setting and level of care. The position creates...
and continued hospital stay applying appropriate clinical criteria. Performs admission review within 24 hours or the first business... and is responsible for coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable...
EDUCATION/ QUALIFICATIONS: · Graduate from an accredited school of Vocational nursing required · Licensed Vocational Nurse... will be required of all certified individuals. JOB KNOWLEDGE/EXPERIENCE: · Three years hospital nursing clinical experience preferred · Case...
informed decisions. By serving as the link between patients and the appropriate health care personnel, the Clinical Review... Review target outcomes, and discharge plans with providers and families Complete all SNF concurrent reviews, updating...
informed decisions. By serving as the link between patients and the appropriate health care personnel, the Clinical Review... Review target outcomes, and discharge plans with providers and families Complete all SNF concurrent reviews, updating...
and continued hospital stay applying appropriate clinical criteria. Performs admission review within 24 hours or the first business... and is responsible for coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable...
. Conducts concurrent review of patient records on admission to the hospital and as determined by the patient's clinical... in utilization review process by contacting patients' insurance companies to provide clinical information to authorize patient...
Position Purpose A clinical position that works within a collaborative process to assess, plan, implement, coordinate... appropriate utilization of care and services, and cost effective outcomes. The Case Manager is responsible for the review of the...
code assignments Perform clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise... citations and demonstrate working knowledge of clinical criteria documentation requirements used to successfully substantiate...
. Provides the clinical information requested by the managed care companies as part of the concurrent review in a timely fashion... to discuss plan of care and coordination of services based on clinical needs and available resources. 3. Utilization Review...
clinically-based concurrent and retrospective review of medical records documentation in support of accurate MS-DRG and APR-DRG... and monitor Clinical Documentation Improvement (CDI) education programs for CDI Specialists, coding specialists, clinical nursing...
code assignments Perform clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise... citations and demonstrate working knowledge of clinical criteria documentation requirements used to successfully substantiate...
Department BSD SUR - Plastics and Reconstructive Surgery: Clinical About the Department At UChicago Medicine, faculty... team, using advanced clinical skills and knowledge to provide assessment, evaluation, testing, treatment, therapies...
denies payment for days during concurrent review, contact the attending with this information. The attending can... for concurrent appeal of the denial Qualifications Education: Registered professional nurse licensed to practice in the state...
Functions: Utilization Management- Utilization Review and Care Transitions & Coordination Providing clinical information... and/or as required by insurer, (concurrent and retro) for medical and/or psychiatric appropriateness according to Hospital's approved criteria...
·Excellent benefits Key Functions/Responsibilities: ·Provides clinical case review, consultation and oversight... for all physician reviewers, including the contracted physicians ·Conducts clinical review of appeals and grievances in a fashion...
through the continuum of care. Responsible for financial, clinical, and discharge planning evaluation for each assigned... for efficient and effective outcomes as related to quality, clinical and cost areas. Responsibilities: Manages an assigned caseload...
record monitoring Coordinates communication with third party payers, external review agencies and the Utilization Committee... Initiate and monitor clinical care guidelines and analyze positive and negative variances Ensure continuity of care through...
including: Concurrent review of all patients to validate that the appropriate patient status is assigned upon admission... in InterQual and/or MCG competency testing. 8. Perform telephonic, and if appropriate, on-site initial/concurrent review...