. PandoLogic. Category:Healthcare, Keywords:Utilization Review Nurse, Location:Mission Hills, CA-91346...Description Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct...
utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission...Job Category: Health Information Management Job Description: Provide prospective, retrospective, and concurrent...
%) Performs prospective, concurrent, post-service, and retrospective claim medical review processes. Utilizes clinical judgement...) criteria (MCG, InterQual), concurrent review, and discharge planning. Preferred: Consistent Critical Care experience...
, protocols, and guidelines. Conducts concurrent review by telephone or on-site and retrospective review by reviewing facility.... As we continue to build something great, we are looking for a Utilization Case Manager to assess plans and coordinate optimal...
and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity... Hospitals by Becker’s Hospital Review in 2018 and as among the 100 Top Hospitals by IBM Watson Health. Chino Valley Medical...
Concurrent Review Utilization Management Nurse will report to the FEP Utilization Management Manager. In this role... California RN License Requires at least 5 years of prior relevant experience * Previous experience in utilization management...
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...
and Utilization Management Possession of an active, unrestricted, and unencumbered Registered Nurse (RN) license issued by the... Transitional Nurse, Rn, you’ll lead risk assessments, oversee reviews, and ensure seamless transitions between care settings. Dive...
and retrospective review of inpatient medical records to evaluate the utilization and documentation of acute care services. Duties... include but not limited to: Providing clinically based concurrent and retrospective review of inpatient medical records...
and retrospective review of inpatient medical records to evaluate the utilization and documentation of acute care services. Duties... include but not limited to: Providing clinically based concurrent and retrospective review of inpatient medical records...
care, communicating with health plans (including concurrent review, which assists the hospitalist/specialist and case... nursing experience required 3 years of previous experience in case management, discharge planning, utilization review...
evidence based review guidelines to conduct utilization review as is appropriate to match the payor Investigates, processes..., refers to nurse practitioner and case manager assigned to the SNF's for continued review and follow up. Authorizes...
evidence based review guidelines to conduct utilization review as is appropriate to match the payor Investigates, processes..., refers to nurse practitioner and case manager assigned to the SNF's for continued review and follow up. Authorizes...
evidence based review guidelines to conduct utilization review as is appropriate to match the payor Investigates, processes..., refers to nurse practitioner and case manager assigned to the SNF's for continued review and follow up. Authorizes...
review and utilization management The RN CM will: Conduct initial review at POE or within 24 hours of admission utilizing.... California Registered Nurse (RN) - CA Board of Registered Nursing Preferred Qualifications Bachelor's Degree in 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...
, training, evaluation and support to department staff in coordinating care and resource utilization. Serves as a role model... policies and procedures. Conducts on-going review and audits of team work to ensure program goals, quality standards...
criteria When H&C Transitions is delegated for utilization management, review referral requests that cannot be approved... Review Coordinator- Onsite is responsible for ensuring efficient, smooth, and prompt transitions of care. If you reside...
for SNF setting (as indicated) according to CMS criteria When H&C Transitions is delegated for utilization management, review... informed decisions. By serving as the link between patients and the appropriate health care personnel, the Clinical Review...
for SNF setting (as indicated) according to CMS criteria When H&C Transitions is delegated for utilization management, review... informed decisions. By serving as the link between patients and the appropriate health care personnel, the Clinical Review...