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Keywords: Clinical Review Nurse - Concurrent Review, Location: USA

Page: 18

LVN Case Manager - FT Days - Res Mgmt

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...

Company: DHR Health
Location: Edinburg, TX
Posted Date: 26 Sep 2025

LVN Case Manager - FT Days - Res Mgmt

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...

Company: DHR Health
Location: Edinburg, TX
Posted Date: 25 Sep 2025

Care Coordinator, Utilization Management

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...

Posted Date: 25 Sep 2025

DRG RN Auditor

of clinical criteria documentation requirements used to successfully substantiate code assignments Perform clinical coding review... to ensure accuracy of medical coding and utilize clinical expertise and judgment to determine correct coding and billing...

Company: CPS Solutions
Location: Plymouth, MN
Posted Date: 25 Sep 2025
Salary: $34.23 - 61.15 per hour

Utilization/Case Manager (Full Time) Days-Remote

needed. Utilization Management: When assigned UM tasks, the UM/CM must: Perform pre-authorization, concurrent, and discharge review... of a team to provide referral, authorization, medical review, and/or case management services to providers and Health Plan...

Company: Mercy
Location: Chesterfield, MO
Posted Date: 25 Sep 2025

DRG RN Auditor

of clinical criteria documentation requirements used to successfully substantiate code assignments Perform clinical coding review... to ensure accuracy of medical coding and utilize clinical expertise and judgment to determine correct coding and billing...

Company: CPS Solutions
Location: Plymouth, MN
Posted Date: 25 Sep 2025
Salary: $34.23 - 61.15 per hour

Case Manager

and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity... is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic...

Posted Date: 25 Sep 2025

Care Coordinator, Utilization Management

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...

Posted Date: 25 Sep 2025

Quality Management Specialist II

, NSQIP, STS, and ACC) utilizing electronic processes and when indicated, concurrent chart reviews Perform daily chart review... Summary: * Responsible for chart abstraction and submission of clinical data to national registries with publicly reported...

Company: Emory Healthcare
Location: Atlanta, GA
Posted Date: 24 Sep 2025

Case Manager

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...

Posted Date: 24 Sep 2025

Senior Solution Architect, Nursing

implementation, Multi-Disciplinary Rounding, and various nurse chart review and documentation optimizations. The ideal candidate... required changes and enhancements to clinical applications, and a a group of analysts leading projects that will standardize...

Company: Oracle
Location: USA
Posted Date: 24 Sep 2025

Care Manager-Care Management-Per Diem-Day-Mount Sinai Queens

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...

Posted Date: 24 Sep 2025
Salary: $58.81 - 63.13 per hour

Sr. Spec-PI-Quality/Safety

in identifying real and potential quality issues through measurement and analysis along with concurrent and retrospective review... and presenting clinical quality-related data. Previous case review experience. Preferred Qualifications Master's Degree...

Company: Sharp HealthCare
Location: La Mesa, CA
Posted Date: 24 Sep 2025
Salary: $51880 - 82000 per year

RN Inpatient Case Manager

for appropriateness of setting, utilization, care planning quality, and facilitates discharge planning on admission and concurrent basis... to discharge planning and mandated reporting. Review admissions, level of care, and continued stay while utilizing nationally...

Location: Lafayette, IN
Posted Date: 24 Sep 2025

RN Care Manager, Medicare

related to requests for services which includes a clinical record review and interviews with members, clinical staff, medical... services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...

Location: New York City, NY
Posted Date: 21 Sep 2025
Salary: $85000 per year

RN Utilization Manager, Health Plans

related to requests for services which includes a clinical record review and interviews with members, clinical staff, medical... services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...

Location: New York City, NY
Posted Date: 21 Sep 2025
Salary: $85000 per year

RN Care Manager, Medicare

related to requests for services which includes a clinical record review and interviews with members, clinical staff, medical... services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...

Location: New York City, NY
Posted Date: 20 Sep 2025
Salary: $85000 per year

Senior Improvement RN-Cleveland Medical Center

on Voice of the Customer (VOC) service needs and expectations. Review care of patients (concurrent and retrospective) to assess...Description A Brief Overview The Senior Improvement Nurse serves as a strategic partner, responsible...

Company: Lake Health
Location: Cleveland, OH
Posted Date: 20 Sep 2025

Quality Assurance RN

Nursing. Upon hire: Oregon Registered Nurse License 5 years Clinical experience. 5 years Hospital experience... concurrent and retrospective support managing initiatives to comply and in accordance with Center for Medicare and Medicaid...

Posted Date: 20 Sep 2025

Quality Assurance RN

Nursing. Upon hire: Oregon Registered Nurse License 5 years Clinical experience. 5 years Hospital experience... concurrent and retrospective support managing initiatives to comply and in accordance with Center for Medicare and Medicaid...

Posted Date: 20 Sep 2025