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Keywords: Clinical Review Nurse Concurrent Review, Location: USA

Page: 18

Claims Utilization RN

Description The Utilization Review/Management (UR/UM) Nurse position will work in in our UR/UM department. An overview of the work... requests for medical services to ensure they meet guidelines before treatment is provided. Concurrent Review: Evaluate...

Company: MedTrust
Location: Oklahoma City, OK
Posted Date: 28 Sep 2025

Utilization Reviewer

about making a meaningful impact in both clinical and behavioral health? Our department stands out for its innovative, patient... and some holidays. General Summary Under general supervision, provides utilization review and denials management for an assigned...

Posted Date: 27 Sep 2025

Chief Quality Officer - St. Joseph Medical Center

, safety, and physician peer review activities for the hospital and outpatient departments. The CQO must: Drive quality... Develop a process to review and implement best practice to reduce variances and improve quality: Implement a comprehensive...

Posted Date: 27 Sep 2025

RN Case Manager John C Lincoln

management or care coordination services. Performs concurrent review of patient treatment plans in accordance with the hospital... with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical...

Company: HonorHealth
Location: Arizona
Posted Date: 27 Sep 2025

Utilization Reviewer

about making a meaningful impact in both clinical and behavioral health? Our department stands out for its innovative, patient... and some holidays. General Summary Under general supervision, provides utilization review and denials management for an assigned...

Posted Date: 27 Sep 2025

Burn Quality RN Specialist - Burn Program - Full Time Days

. Job Responsibilities: Data Abstraction - 45% - Completes concurrent and retrospective data abstraction on burn registry cases... and correcting as needed using routine inter-rater reliability (IRR) review, report running, and data drilldowns. - Identifies data...

Company: Grady Health
Location: Georgia
Posted Date: 27 Sep 2025

Care Coordinator, Onsite - Cumming, GA (Hybrid RN, PT, OT, ST)

: 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...

Company: CPS Solutions
Location: Cumming, GA
Posted Date: 27 Sep 2025
Salary: $34.23 - 61.15 per hour

CDI Specialist RN

family medicine and transitional year. Job Summary Provides thorough concurrent review of medical record clinical... to capture needed documentation. Able to conduct thorough medical record review on initial and extended-stay concurrent reviews...

Posted Date: 27 Sep 2025

Care Coordinator, Onsite - Cumming, GA (Hybrid RN, PT, OT, ST)

: 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...

Company: CPS Solutions
Location: Cumming, GA
Posted Date: 27 Sep 2025
Salary: $34.23 - 61.15 per hour

CDI Specialist RN

family medicine and transitional year. Job Summary Provides thorough concurrent review of medical record clinical... needed documentation. Able to conduct thorough medical record review on initial and extended-stay concurrent reviews on all selected...

Posted Date: 27 Sep 2025

Care Transitions RN

as defined by the Nebraska Nurse Practice Act. Minimum of two (2) years recent clinical experience required. Prior care... review activities, including concurrent and retrospective reviews as required. Determines the medical necessity of request...

Company: Bryan Health
Location: Lincoln, NE
Posted Date: 27 Sep 2025

Case Manager RN

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...

Company: Prime Healthcare
Location: Woonsocket, RI
Posted Date: 27 Sep 2025

RN Case Manager John C Lincoln

and coordinates transition to next level of case management or care coordination services. Performs concurrent review of patient... in Case Management - Preferred 7 years as a Registered Nurse (RN) - Preferred Other Experience in an outpatient clinical...

Company: HonorHealth
Location: Arizona
Posted Date: 26 Sep 2025

Case Manager RN

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

Posted Date: 26 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: 25 Sep 2025

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

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

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

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