. Coordinates services between hospital departments to facilitate timely patient discharge. Conducts concurrent review of patient... in utilization review process by contacting patients' insurance companies to provide clinical information to authorize patient...
Job Description: DEPARTMENT: 17117 - Clinical Documentation Integrity LOCATION: 350 7th Street North, Naples, FL... in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass...
perspective on workplace flexibility. Position Purpose: Supervises Prior Authorization, Concurrent Review, and/or Retrospective... Review Clinical Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management...
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...
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...
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...
utilization management position that has core responsibilities in the areas of inpatient concurrent review, pre and post service... utilization review, and collaboration with RN Case and disease managers. This director position will report to the Sr. Medical...
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...
facility CMs. Assists with concurrent and retrospective utilization review activities including denials and appeals. Works... with physicians to conduct peer review with payer medical director when indicated. Ensures clinical updates are provided...
Overview: To provide daily oversight, leadership, support, training and direction of both clinical and non-clinical... and clinical resource to colleagues, staff, members and others. Assists department leadership in identifying, monitoring...
underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care... Support and coaching of clinical documentation efforts Coordinating communication with physicians Must be able...
: Active, unrestricted registered clinical license required in state of hire - Registered Nurse, Physical Therapist... and facilitate informed decisions. By serving as the link between patients and the appropriate health care personnel, the Clinical...
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...
by concurrent and retrospective denial of payments for services provided. Collaborates with physicians, Utilization Review RN.... Serves as a resource to all staff in areas of utilization review/management. Utilizes and analyzes current medical/clinical...
. 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...
: Active, unrestricted registered clinical license required in state of hire - Registered Nurse, Physical Therapist... and facilitate informed decisions. By serving as the link between patients and the appropriate health care personnel, the Clinical...
. Requires a minimum of 4 years of clinical experience and/or utilization review experience. Current active, valid..., consistent administration of plan benefits by reviewing clinical information and assessing medical necessity under relevant...
. Meet monthly with Clinical Partner. Serve as primary HR contact for concurrent student/employee issues. Ensure timely... follow clinical policies and document student outcomes on time. Review learning materials & contribute updates at curriculum...