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...general supervision of the Director of Case Management, the Utilization Review Nurse provides a clinical review of cases using medical necessity... ...communication with the health plan, clinical providers (HMH Physicians/NPs) and care coordination departments regarding medical...
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...serving the pediatric and adolescent population, is seeking a Utilization Review Coordinator (RN)
ESSENTIAL FUNCTIONS:
1. Responsible for... ...in treatment team meetingsto report said legitimacy to physicians and team members.
QUALIFICATIONS:
•Threeto five years...
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...Mesa Springs is looking for a licensed Counselor to join our Utilization Review department at our Arlington location! This full-time... ...between the facility treatment provider and the managed care physician.
Assists the Assessment Department with completion of the...
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Title: RN Utilization Review II
Description: The RN Utilization Review II is responsible for determining the clinical appropriateness of... ...and comprehensiveness of documentation and collaborates with physician and treatment team to obtain documentation needed to support...
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Permanent employment
Immediate start
...Directs the Clinical Resource Management department to include the Utilization Management (UM) plan and associated programs to impact resource management and compliance of all state, federal and accreditation requirements. Minimum Specifications Educ Management, Director...
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Temp to Perm - Local Candidates only. Current RN Compact license required
Summary:
The RN Utilization Review II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services....
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Local area
...supervision, assigns medical necessity requests to a qualified reviewer and follows-up to ensure timely determination is delivered... ...:
The Details
Communicates directly with customer and physician advisor and tracks cases to ensure case is completed and returned...
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ezURS.com Inc., has an ongoing need for Pain Management Physician Consultants to perform a wide variety of world-class utilization review, disability, peer reviews products in multiple lines of business including health, workers compensation, and auto liability cases....
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...Job Description
TRS Healthcare is seeking a travel nurse RN Utilization Review for a travel nursing job in Irving, Texas.
Job Description & Requirements
~ Specialty: Utilization Review
~ Discipline: RN
~ Start Date: 05/27/2024
~ Duration: 12 weeks
~40...
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Shift work
...for analyzing medical records for medical-legal reviews. After analyzing provided clinical documentation, Utilization Review Nurses must create a professional... ...executive summary will review the patient’s condition, physician orders, summarize and discuss course of...
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ezURS.com Inc., has an ongoing need for Physician Consultants to perform a wide variety of world-class utilization review, disability, peer reviews products in multiple lines of business including health, workers compensation, and auto liability
Opportunity to work remotely...
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Full time
Immediate start
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...shifts. Saturday, Sunday, Monday.
JOB SUMMARY
The Utilization Review Registered Nurse (RN) provides a clinical review of cases using... ...Alerts and partners with appropriate Utilization Review, Physician leadership and/or Provider Team personnel concerning patients...
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Immediate start
Remote job
Shift work
Weekend work
Sunday
Saturday
$80k - $90k
...We are seeking an experienced Utilization Management RN to join our esteemed surgical center... ...minimum of 2 years Utilization Management/Review in an acute care setting, Minimum of 2... ...Attends these meetings, times vary based on physicians schedule- Once per quarter
Benefits--...
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...Resource Management department to include the Utilization Management (UM) plan and associated... ...of leadership experience in Utilization Review or Care Management.
Equivalent... ...the medical staff, Chief Medical Officer, Physician Advisors, and Care Coordination to...
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...maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a... ...a NM, TX, MN, and/or NC License.
Physician Specialties: Radiation Oncology,... ..., Hematology/Oncology
JOB SUMMARY
Utilizes clinical expertise and reviews insurance...
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...We are seeking flexible and experienced physicians for our medical reviewstream division.... ...SUMMARY:
Relying on clinical background, reviews health claims providing medical... ...files and provides recommendations for utilization review, chart reviews, medical necessity...
Contract work
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Monday to Friday
...Peer Review Coordinator RN
Overview
CHI St. Joseph Health - College Station/Bryan... ...employed providers including primary care physicians specialists and advanced practice... ...and assists physicians with peer review utilizing medical staff indicator criteria. Enters...
...help.
Website:
Position Summary
The Director of Utilization Review is responsible for directing and overseeing the Utilization... ...and ambulatory care access points, an insurance offering, a physician network and various related
services located all over the...
Local area
The Professional Review Nurse provides analysis of medical services to determine appropriateness... ....Clinical and/or technical expertise is utilized to address the provision of medical care... ...with the claims adjusters, attorneys, physicians and their representatives, and advisors/...
Minimum wage
Full time
Local area
Flexible hours
Innova Solutions is immediately hiring a Utility Worker Position type: Full-time - Contract Duration: 12 Months Location: San Antonio, Texas As a Utility Worker, you will:
Sets up barricades and traffic cones. Acts as flagman to direct traffic as times. Breaks ground...
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