for SNF setting (as indicated) according to CMS criteria When H&C Transitions is delegated for utilization management, review... regulatory policies related to utilization management and care coordination (CMS guidelines, Health Plan policies, and benefits...
for SNF setting (as indicated) according to CMS criteria When H&C Transitions is delegated for utilization management, review... regulatory policies related to utilization management and care coordination (CMS guidelines, Health Plan policies, and benefits...
for. The MSL will continue to enhance their skills and agility, applying the competencies of Change Management, Time Management.... Qualifications: PharmD, PhD, MD, or other advanced medical degree, NP (Nurse Practitioner), PA (Physician Assistant)), with 2...
and agility, applying the competencies of Change Management, Time Management and Innovation. The MSL is responsible for conducting... guidelines. Qualifications: PharmD, PhD, MD, or other advanced medical degree, NP (Nurse Practitioner), PA (Physician...
’s license, auto insurance and reliable transportation. Two years as a Registered Nurse with at least one-year of management... based on own the review of clinical documentation in addition to feedback and recommendations by Utilization Review staff...
identified in need of comprehensive case management. Promotes effective utilization and monitoring of health services... experience Registered Nurse Basic Life Support (within 90 days) BSN-preferred Case Management (ACM, CCM, CCCTM, CMAC...
and agility, applying the competencies of Change Management, Time Management and Innovation. The MSL is responsible for conducting... (Nurse Practitioner), PA (Physician Assistant)), with 2+ years relevant TA clinical experience Ability to support travel up...
provider conversation for scheduling. Will work with inpatient case management teams, WOCNs As needed will conduct education... resources for assistance. Anticipates patient's needs and advocates for patient rights and appropriate utilization of services...
state license as a Registered Nurse per state regulations A minimum of two (2) years' experience in a nurse management... is responsible for providing leadership and management to the skilled nursing operations. Responsible for planning, organizing...
professionals, playing a key role in establishing product demand and delivering comprehensive account management within a designated... utilization while identifying and addressing the unique needs of each account. This includes building and maintaining...
in utilization review. The role also provides periodic crisis support for distressed callers to the intake line and engages... to treatment so you can expect to work with physicians, psychiatrists, nurses, techs, counseling, and case management. The Recovery...
. Review and address clinical task lists and nurse line messages. Calibrate, clean, sterilize and inventory all equipment... are addressed in a timely manner. Must maintain HIPAA compliance Other duties assigned as deemed necessary by management...
and needs. Crisis & Case Management · Respond to clients experiencing acute and/or chronic psychiatric or emotional crises.... · Create and implement safety plans as needed. · Coordinate care with psychiatrists, nurse practitioners, primary care...
effective resource utilization, program and policy development, implementation and evaluation. As a member of the nursing... service, resource and financial management, efficient and effective system processes and professional development. These...
. Review and address clinical task lists and nurse line messages. Calibrate, clean, sterilize and inventory all equipment... are addressed in a timely manner. Must maintain HIPAA compliance Other duties assigned as deemed necessary by management...
is looking for a RN Clinical Assessor to join our growing team. Job Summary: The purpose of the Registered Nurse (RN) Clinical...: Required qualifications: Active and unrestricted Registered Nurse (RN) license for the State of Virginia or compact license to include...
for preforming duties of utilization review assisting case managers with patient accounts, patient type, and timely payer... of denied cases w/follow up Works w/RAC Coordinator to identify RAC issues/risk areas. Instructs case management department...
. Demonstrates compliance with facility-wide Utilization Management policies and procedures. Coordinates UR compliance with Quality... in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist (RT) OR Medical Social Work (license per state...
that is field based and is comprised of nurses working under the general direction of the Regional Director of Clinical Nurse... relationships with clinical personnel Ensures appropriate and compliant utilization of product and disease state education as it...
. Review and address clinical task lists and nurse line messages. Calibrate, clean, sterilize and inventory all equipment... are addressed in a timely manner. Must maintain HIPAA compliance Other duties assigned as deemed necessary by management...