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...
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...
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...
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...
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...
. 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...
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...
: 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...
. 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...
. 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...
: 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...
Nurse License-NYS Preferred Qualifications: Bachelor's Degree Nursing. New York State Department of Health Patient Review... reviews. Job Responsibilities: Performs other duties as assigned Performs an initial utilization review of patients...
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...
: Associate's Degree: Related Field, Work Experience: Clinical bedside; CDI Responsibilities Conducts the initial concurrent...Job Description: Overview Performs inpatient chart review to determine appropriate DRG assignment and assures...
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...
: Conducts the initial concurrent review process for all selected admissions. Clarifies documentation in the medical record...Overview: Performs inpatient chart review to determine appropriate DRG assignment and assures appropriate documentation...