systematic review of patient throughput including evaluating and implementing strategies and operational improvements to reduce... in staffing, placement of resource pool staff, and/or Agency staff. Assists in the advancement of the professional practice...
of clinical criteria documentation requirements used to successfully substantiate code assignments Perform clinical coding review..., reimbursement trends, and client processes and requirements Maintain and manage daily case review assignments, with a high emphasis...
of clinical criteria documentation requirements used to successfully substantiate code assignments Perform clinical coding review..., reimbursement trends, and client processes and requirements Maintain and manage daily case review assignments, with a high emphasis...
Licensed as a Registered Nurse in the State of Michigan OTHER REQUIREMENTS · For those hired into roles after October 1st.... Assists in the utilization of the PCSS database to ensure appropriate staffing ratios. c. Promotes the integration...
of completing complex post-acute services Interface with utilization review specialists to stay current on patient's eligibility...). If Registered Nurse, must be licensed to practice in Michigan. Also, for those hired into this job after January 1, 2015, it...
areas: Utilization Review Medicaid and/or Medicare appeals to experience LOC assessment planning and Discharge SNF... an initial assessment review of appeals, medical records, and CMS/State Policies to determine if care/services provided meets...
, daily utilization review, and QAPI meetings (falls, skin, weight, infection control etc.). Determines the staffing needs..., active license to practice as a Registered Nurse in this state. Has a minimum, two (2) years of experience as a supervisor...
Nurse Case Manager (NCM) is responsible for Complex Case Management, Disease Management and Transitional Case Management... management through the care continuum. Nurse Case Manager will identify, screen, track, monitor and coordinate the care...
in conjunction with SFHN and provides a range of mental health and substance use treatment services. The candidate pool resulting... to nursing service 5. Review daily work assignments to ensure they meet regulatory compliance and provide consistent staffing...
Experience in discharge planning Experience in utilization review, concurrent review, or risk management A background... decision support for members, requiring a Registered Nurse (RN) qualification. The Case Manager plays a critical role...
Experience in discharge planning Experience in utilization review, concurrent review, or risk management A background... decision support for members, requiring a Registered Nurse (RN) qualification. The Case Manager plays a critical role...
. Maintains and manages daily case review assignments, with accountability to quality, utilization, and productivity standards... Responsibilities Performs clinical review of CPT, HCPCS, and modifiers assigned to codes on claims in a telecommuting work...
. Maintains and manages daily case review assignments, with accountability to quality, utilization, and productivity standards... Responsibilities Performs clinical review of CPT, HCPCS, and modifiers assigned to codes on claims in a telecommuting work...
review of CPT, HCPCS, and modifiers assigned to codes on claims in a telecommuting work environment Determines accuracy..., evidence of fraud, waste, or abuse, and recommends providers to be flagged for review Maintains and manages daily case review...
in a review of claims. They need to effectively manage their caseload and monthly metrics in a production driven environment...* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Performs clinical review of CPT, HCPCS...
in a review of claims. They need to effectively manage their caseload and monthly metrics in a production driven environment...* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Performs clinical review of CPT, HCPCS...
in a review of claims. They need to effectively manage their caseload and monthly metrics in a production driven environment...* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Performs clinical review of CPT, HCPCS...
of clinical criteria documentation requirements used to successfully substantiate code assignments Perform clinical coding review..., reimbursement trends, and client processes and requirements Maintain and manage daily case review assignments, with a high emphasis...
in a review of claims. They need to effectively manage their caseload and monthly metrics in a production driven environment...* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Performs clinical review of CPT, HCPCS...