Utilization Review Specialist Part time\weekends
Vidant Medical Center - Greenville, NC
Utilization Review Specialist Part time\weekends The Utilization Review Specialist will ensure regulatory compliance with CMS Conditions... of Participation with regard to Utilization Management. Perform Utiliztion Review according to CMS and commercial payor guidelines. Participate in denial...
Registered Nurse- Utilization Management
Review services. REGISTERED NURSE, UTILIZATION MANAGER. Possess a Baccalaureate Degree in Nursing, a Nursing Diploma, or an Associate Degree in....The health care worker shall perform utilization management activities that include retrospective, prospective, and concurrent review...
Remote RN Utilization Review Coordinator - WY, CO, MT, UT
Work from home as an RN Utilization Review Coordinator in the Wyoming, Colorado, Montana, or Utah area. Candidate will be responsible... a Utilization Review/Clinical Consultation... Telecommute in the Lake Mary, Florida area as a full-time utilization review RN. Evaluate needs...
Utilization Management Frontline Leader
seeks a Remote Utilization Management Nurse. Candidate will perform review services to determine if... Company seeks a Virtual Commercial Case...Company seeks a Virtual Utilization Management Frontline Leader. Candidate will hire, lead, and develop clinical and non-clinical...
Director of Utilization Review and Palliative Care
Wheaton Franciscan Healthcare - Milwaukee, WI
working as part of an interdisciplinary team. deep Background in standards implementation and quality improvement in utilization review... certification or within one year of hire Description: Hospital Utilization Management and Palliative Care programs with a dual focus on certification...
Kaiser Permanente Northwes - Fontana, CA
required. • Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of utilization review/management... Utilization. • Will be trained to assist with Medi-Cal TARs and Utilization quality review. • May be required to travel to offsite locations...
Remote Utilization Management Nurse
Phoenix, AZ - Los Angeles, CA
Company seeks a Remote Utilization Management Nurse. Candidate will perform review services to determine if medical treatment... a utilization management nurse in the Phoenix, Arizona area. Conduct utilization... A utilization management nurse is needed to work from home in...
Medical Director, Commercial Clinical Policy Review
Humana - Tampa, FL
, maintain and assure compliance with physician review policies and procedures (including timeliness) for utilization management and support case...Medical Director, Commercial Clinical Policy Review Requisition ID 84883 Business Overview Humana Inc., headquartered in Louisville...
Dental Clinical Review Director
UnitedHealth Group - Columbia, MD
DENTAL CLINICAL REVIEW DIRECTOR Position will manage clinical aspects of dental Utilization Review; lead identification and investigation... outreach; clinical liaison to internal and external entities related to UM/UR and FWA. Manage clinical aspects of Utilization Review and the Fraud...
Sedgwick - Chicago, IL
Utilization Review RN Utilization Review Registered Nurse CLAIM YOUR FUTURE AS A GREAT PERFORMER!Continuing double-digit revenue growth... effective alternatives to acute care.ESSENTIAL FUNCTIONS and RESPONSIBILITIESDelivers utilization review services; i.e., administrative continued...
Director of Coordinated Care /Discharge Planning/Utilization Review
Southern Medical Recruiters - Louisiana
DIRECTOR COORDINATED CARE/Utilization Review/Discharge Planning Work Schedule: Days Average Hours per Week: 40 Travel Involved: 0-10..., organizing, developing and directing the hospital's utilization review and discharge planning programs. Specific responsibilities include...
Nursefinders - Towson, MD
Utilization Review If you are looking for reliable nursing jobs at quality facilities, with competitive pay, look to Nursefinders. You’ll... Include:8 Week Contracts for Utilization Review8 Week Contracts for PEDS NightsICU Per Deim - Multiple openingsPsych Per Deim - Multiple...
Case Manager (RN),Utilization Review Nurse (RN)
Randstad Healthcare - Coral Gables, FL
This facility has been one of South Florida’s most respected hospitals for more than 60 years. This award winning, Magnet hospital and its surrounding affiliates is the largest not-for-profit health care organization in the region. This hospital itself is constructed in Italian R...
Utilization Review Nurse (RN),Case Manager (RN),Hospital Case Manager (RN)
Randstad Healthcare - Palmer, MA
This 52-bed facility is affiliated with a large teaching hospital and is currently expanding. The 58,000 square foot addition is on its way to completion and will replace the inpatient and ambulatory care units as well as add a new entrance for admissions. With it will bring stat...
Randstad Healthcare - Golden Valley, MN
Clinical Analyst- Nurse with informatics or statistician background needed for Golden Valley MN....
Business Specialist/Leadership - Atlanta, GA
admission reviews of pre-hospitalized and hospitalized patients. Knowledgeable of federal and state hospital Utilization Review (UR) regulations... licensure. Previous hospital experience in Utilization Review.ESSENTIAL FUNCTIONS:1. Engages in activities that promote proper utilization of the...
Health Integrity - Easton, MD
that demonstrates expertise in utilization review, ICD-9 coding, CPT coding, and Medicare or Medicaid claims data. Prior successful experience with CMS... review for Medicare, Medicaid, or other claims data in order to ensure that proper guidelines have been followed and acts as a facilitator...
QualStaff Resources - Tampa, FL
or utilization review? QualStaff is working with a well-established insurance company in the Miami area to fill multiple Utilization Review Nurse... and challenging position Collaborating with a team of other experienced nurses Keywords: Utilization Review, Insurance, Infusion, Triage Nurse, LPN, Nurse...
Utilization Review Registered Nurse for Health Plan
Medix Staffing Solutions, Inc. - Boston, MA
We are looking for a Utilization Review RN to fill an immediate need immediately outside Boston. He/she would would be responsible mainly... of MA ** Preferred: Background in Concurrent Review/Utilization Management in acute or managed care setting. ...
RN - Utilization Review Nurse - Managed Care
Nurse Resolutions - Seattle, WA
manager, case management, utilization review, utilization management, concurrent review, medical review, HEDIS, CCM, CPUR, Medicaid, Seattle... services procedures and facilities. Licensed RN responsible for clinical review of all acute and subacute services for appropriateness based...