) years of hire. Individual consideration may be given to a registered nurse, with significant clinical experience, who holds... of clinical experience: five (5) years of experience in an acute care setting with strong care management, utilization review...
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...
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...
Nursing. Upon hire: Oregon Registered Nurse License 5 years Clinical experience. 5 years Hospital experience...Job Category: Clinical Quality Job Description: Provides assessment, evaluation and support for all quality...
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...
of hospital, state, and national trauma registry. This position is responsible for the clinical case management and care... providers and prompt identification relating to trauma performance improvement activities on a concurrent basis. Education...
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...
of hospital, state, and national trauma registry. This position is responsible for the clinical case management and care... providers and prompt identification relating to trauma performance improvement activities on a concurrent basis. Education...
of hospital, state, and national trauma registry. This position is responsible for the clinical case management and care... providers and prompt identification relating to trauma performance improvement activities on a concurrent basis. Education...
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...
Job Description: Responsibilities Registered Nurse RN Joint Replacemtn Institute Full-Time Days St. Mary... plan of care of nurse action, implementation of the plan of care and the evaluation of the process, by use of the nursing...
patient population; b. Provides the clinical information requested by the managed care companies as part of the concurrent... review in a timely fashion. c. Provides clinical information requested by the managed care companies in accordance...
Job Description: Responsibilities Registered Nurse RN Joint Replacemtn Institute Full-Time Days St. Mary... plan of care of nurse action, implementation of the plan of care and the evaluation of the process, by use of the nursing...
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...
by the managed care companies as part of the concurrent review in a timely fashion. c. Provides clinical information... of services based on clinical needs and available resources. Utilization Review: a. Maintains a working knowledge of the UR...
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...
as specified by Insurance / State & Federal regulation. Enters concurrent review information for Review Nurses in Allscripts... Mail - Sort, identifies location and distribute to appropriate departments Monitors Concurrent Nurse denial phone calls...
. Duties/Responsibilities: A. Utilization Management Performs review of anticipated admissions utilizing InterQual criteria... of care based on initial assessment and concurrent collaboration with other care givers, external service organizations...
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...