managed care requirements and pre-certification/authorization needs are met prior to patient admission. Assist with flow... to department goals by making 100% of financial arrangements for each patient prior to services being performed. o Review patient...
managed care requirements and pre-certification/authorization needs are met prior to patient admission. Assist with flow... to department goals by making 100% of financial arrangements for each patient prior to services being performed. o Review patient...
managed care requirements and pre-certification/authorization needs are met prior to patient admission. Assist with flow... to department goals by making 100% of financial arrangements for each patient prior to services being performed. o Review patient...
Overview: The Ambulatory Nurse utilizes a systematic approach to nursing by incorporating assessment, planning... to improve the quality of care or clinical outcomes. Assists Nursing Supervisor/coordinator in the development of departmental...
Outcomes Review clinical documentation to ensure clinicals provided supports desired outcomes prior to submitting to payor... information to insurance payors, outcomes must decrease the need to peer-to-peer review. Work with the Payor Nurse Navigators...
. Duties/Responsibilities: A. Utilization Management Performs review of anticipated admissions utilizing InterQual criteria... smooth care transitions by ensuring appropriate clinical follow-up is arranged and referrals to proper post-acute providers...
. Graduate education and related Texas Board of Nursing authorization must be consistent with clinical practice area and patient... population. OR * Graduate of a master's degree or higher Accreditation Review Commission on Education for the Physician Assistant...
cases for authorization for in patient stay. Staff review short stay, long stay and complex cases to affect and ensure.... Communicates with the transferring hospital, Patient Access and physicians and payers for authorization prior to transfer...
cases for authorization for in patient stay. Staff review short stay, long stay and complex cases to affect and ensure.... Communicates with the transferring hospital, Patient Access and physicians and payers for authorization prior to transfer...
cases for authorization for in patient stay. Staff review short stay, long stay and complex cases to affect and ensure.... Communicates with the transferring hospital, Patient Access and physicians and payers for authorization prior to transfer...
and/or registered nurse(s) in various ambulatory settings. Clinical direction, oversight and competency review is provided by medical... reports and miscellaneous correspondence in EMR and attaches results to appropriate orders. May obtain prior authorization...
, providers and/or registered nurse(s) in various ambulatory settings. Clinical direction, oversight and competency review... reports and miscellaneous correspondence in EMR and attaches results to appropriate orders. May obtain prior authorization...
including in the NCH Palliative Care Clinic if indicated. Explore if prior authorization for pain medication... in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass...
/Certification Healthcare professional licensure required as Registered Nurse, or Licensed Clinical Social Worker (LCSW... years of experience in a healthcare setting preferred Prefer prior experience in case management, utilization review...
with or complete prior authorization process. Assists patients with resources for any social influences of health needs. Participates... Review document, relative to position. ESSENTIAL QUALIFICATIONS: EDUCATION: Graduate of an accredited Registered Nurse...
) with required information (diagnosis listed prior to patient check out. Review all ordered tests for accuracy and for Precert requirements... required. Patient care clinical skills required. Bilingual, Spanish fluency, both written and speaking skills desired. Equipment...
with or complete prior authorization process. Assists patients with resources for any social influences of health needs. Participates... Review document, relative to position. ESSENTIAL QUALIFICATIONS: EDUCATION: Graduate of an accredited Registered Nurse...
required. Patient care clinical skills required. Bilingual, Spanish fluency, both written and speaking skills desired. Equipment.../A Ensure all required forms are in the chart prior to the patient receiving services. Obtain authorized signatures...
background within a managed care setting including a high-level understanding of prior authorization process from beginning... with Clinical Program leaders to execute on programmatic audit results and ensure existing and new regulatory initiatives. Review...
Job Description: Overview The Procedural Nurse utilizes a systematic approach to nursing by incorporating... - American Heart Association (AHA); Licensed Registered Professional Nurse (RN) - Illinois Department of Financial...