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Full-time Utilization Registered Nurse
IA Recruiting
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Baltimore, MD
$38.20-$59.21 hourly experience based
... Essential Functions: Chart Review Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource consumption. Denial Management Monitors and identifies patterns or trends in utilization management. ... - May 30
Registered Nurse Utilization Management Case Management Emergency Dept
McLaren Oakland
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Pontiac, MI, 48342
35.84USD - 53.75USD per hour
Job Description Department: Utilization Management Scheduled Bi-Weekly Hours: 80 Daily Work Times: 11am-7pm Position Summary ... Sends accounts to secondary reviewer as necessary. Provides guidance to providers and clinical staff regarding documentation ... - Jun 06
Utilization Management Specialist - RN
Sanford Health
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Sioux Falls, SD, 57108
... Performs utilization management (UM) activities in accordance with UM plan to assure compliance with accreditation/regulatory requirements. Completes/coordinates activities relating to the implementation, ongoing evaluation, and improvements to UM ... - Jun 05
Hospital Reviewer/Utilization Manager
DOCTORS HEALTHCARE PLANS, INC.
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Coral Gables, FL, 33134
... Responsibilities: Uses a collaborative process to plan, assess, re-assess, implement, monitor, and evaluate the options and services required to meet the healthcare needs of the patients using the functions of Utilization Resource Management, ... - Jun 06
Clinical Reviewer
Independent Health Association
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Buffalo, NY
... Overview The Clinical Reviewer will be responsible for the collection and review of medical records specific to quality ... Utilization Management experience preferred. Comprehensive knowledge and experience with managed care benefit plans. Ability ... - Jun 05
Director of Case Management
UT Health Tyler
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Tyler, TX, 75701
... POSITION SUMMARY The Director Case Management has overall responsibility for hospital case management, social work, transition management and operational management of the case management department to promote effective utilization of hospital ... - Jun 06
Licensed Clinical Reviewer
Texas Care
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Bammel Village, TX, 77014
75000USD per year
Job Description Position Summary: Texas Care Licensed Clinical Reviewer is responsible for processing authorization requests ... Familiar with Texas Medicaid Provider Procedures Manual and utilization guidelines. · Solid understanding of managed care ... - Jun 06
Travel Nurse RN - Case Management - per week
ND Global Consulting Services
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Cambridge, MA, 02140
... Applies InterQual Inpatient criteria approved by the MACIPA (risk) and MAH (non-risk) Utilization Management Committees to ... Identifies days not meeting acute hospital level of care criteria and reports them to the physician reviewer. 7. Works with ... - Jun 04
Travel Nurse RN - Case Management
ND Global Consulting Services
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Cambridge, MA, 02140
... Applies InterQual Inpatient criteria approved by the MACIPA (risk) and MAH (non-risk) Utilization Management Committees to ... Identifies days not meeting acute hospital level of care criteria and reports them to the physician reviewer.\n 7. Works ... - Jun 06
Travel Nurse RN - Utilization Review - per week
HumanEdge Travel Nursing and Allied Health
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Syracuse, NY, 13235
... Days (8-hour shifts, Mon-Fri) Assignment Length: 13 weeks EMR: Epic experience required Position Overview Join a premier New York acute-care hospital as a Travel RN in Case Management, Utilization Review, and Clinical Documentation Improvement. ... - Jun 04