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...
as needed for the clinical review process Conducts pre-authorization and concurrent clinical reviews requests for services such as DME... years clinical experience as a Registered Nurse in a clinical setting required. 2 years’ experience as a Utilization...
clinical review, concurrent review, and retrospective review. Utilize critical thinking and clinical knowledge to make... and transitions in relation requiring clinical review against plan language and the appropriate clinical criteria. Conduct initial...
comprehensive, concurrent, and retrospective clinical reviews and abstractions as assigned. Assists in the collection... of experience in areas of clinical focus. Other Information: **Florida licensure as a Registered Nurse or trained medical Physician...
Risk Coordinator RN will facilitate peer review activities for nursing and clinical departments and oversee the... to all. They are also responsible for providing clinical expertise and ensuring evidence based practice. Authorized to review and investigate...
or complex continuing care needs and supportive services. Provides an initial review and concurrent reviews...Summary The Inpatient Nurse Care Manager, in collaboration with the multidisciplinary team is responsible...
clinical review, concurrent review, and retrospective review. Utilize critical thinking and clinical knowledge to make... and transitions in relation requiring clinical review against plan language and the appropriate clinical criteria. Conduct initial...
decisions. By serving as the link between patients and the appropriate health care personnel, the Clinical Review Coordinator...: Active, unrestricted registered clinical license required in state of hire - Registered Nurse, Physical Therapist...
decisions. By serving as the link between patients and the appropriate health care personnel, the Clinical Review Coordinator...: Active, unrestricted registered clinical license required in state of hire - Registered Nurse, Physical Therapist...
%) Performs prospective, concurrent, post-service, and retrospective claim medical review processes. Utilizes clinical judgement.... Actively participates in the discharge planning process, including providing clinical review and authorization for alternate...
. Concurrent chart review I. Participation in the inpatient rounds for stroke J. Responds to code strokes when...: A. Stroke policy and procedure development and review B. Responsible for compliance with all Federal and State regulatory...
of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review... Registered Nurse license. Grandfathered prior to April 1, 2015. Minimum 5 years post graduate of an accredited school Of Social...
care. Here, you'll work alongside some of the best clinical talent in the nation leading the way in medical innovation... of the Director of Case Management, the Nurse Case Manager will assess all patients within their defined geographical scope...
and consults with nurse reviewers on pre-authorization, concurrent and retrospective review issues, post-service reviews, pre.... Medical Policy and HPIRIT only: The position has primary responsibility for the medical review for the Clinical Inquiries...
review per Tenet policy. Ensures timely communication of clinical data to payers to support admission, level of care, length... activities: a) accurate medical necessity screening and submission for Physician Advisor review, b) care coordination, c...
level of care, utilization of services, concurrent review, retrospective review, development of discharge plans, assurance... of America's workforce, one patient at a time. Join us at Concentra and see how your clinical competency and compassion can make...
patient discharge. Conducts concurrent review of patient records on admission to the hospital and as determined by the... in utilization review process by contacting patients? insurance companies to provide clinical information to authorize patient...
effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the... seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost...
. Conducts continued stay review as indicated based on clinical condition and third party payor requirements. Collaboratively... assessment, monitoring of the plan of care, review activities, coordination with the interdisciplinary team and any outside third...
and insurance reimbursement issues. Department Position Summary: Responsible for initial and concurrent review of the patient...: Required: Graduate from an accredited school of Nursing. Preferred: Experience: Required: Broad clinical experience...