HYBRID UTILIZATION REVIEW REGISTERED jobs in UNITED STATES, United Kingdom #4

of member appeal and grievance experience. Minimum of two (2) years of experience working on utilization management platform...-processing authorizations. Minimum of two (2) years of experience compiling data for appeal review with regulatory entities...

is delegated for utilization management, review referral requests that cannot be approved for continued stay... using clinical skills and utilizing CMS criteria upon admission to SNF and periodically through the patient stays Review...

is delegated for utilization management, review referral requests that cannot be approved for continued stay... using clinical skills and utilizing CMS criteria upon admission to SNF and periodically through the patient stays Review...

and outpatient mental health cases throughout the entire treatment plan Administer benefits and review treatment plans Coordinate... Work, Counseling, or Marriage and Family Counseling; Licensed Ph.D., or Registered Nurse with 2+ years of experience in...

of experience working in acute care 1+ years of care management, utilization review or discharge planning experience HMO... appropriate utilization of resources and patient quality outcomes. Performs care management functions on-site and telephonically...

, home health care, utilization review, or quality assurance Familiarity with regional physicians CCM, and COHN-S/CM... are optional but highly valued Ability to drive to appointments within a 2-hour radius Active, unencumbered registered nursing...

. Record Review: Completes initial medical records reviews of patient records within 24-48 hours of admission for a specified..., and procedures for accurate MS-DRG assignment, risk of mortality and severity of illness; and (b) initiate a review worksheet...

acute care 1+ years of care management, utilization review or discharge planning experience HMO experience Washington...' care utilizing advanced nursing knowledge, experience, and skills to ensure appropriate utilization of resources...

. Record Review: Completes initial medical records reviews of patient records within 24-48 hours of admission for a specified..., and procedures for accurate MS-DRG assignment, risk of mortality and severity of illness; and (b) initiate a review worksheet...

) according to CMS criteria When naviHealth is delegated for utilization management, review referral requests that cannot be approved... and periodically through the patient stays Review targets for Length of Stay (LOS), target outcomes, and discharge plans...

) according to CMS criteria When naviHealth is delegated for utilization management, review referral requests that cannot be approved... and periodically through the patient stays Review targets for Length of Stay (LOS), target outcomes, and discharge plans...

. Record Review: Completes initial medical records reviews of patient records within 24-48 hours of admission for a specified..., and procedures for accurate MS-DRG assignment, risk of mortality and severity of illness; and (b) initiate a review worksheet...

. Record Review: Completes initial medical records reviews of patient records within 24-48 hours of admission for a specified..., and procedures for accurate MS-DRG assignment, risk of mortality and severity of illness; and (b) initiate a review worksheet...

. Record Review: Completes initial medical records reviews of patient records within 24-48 hours of admission for a specified..., and procedures for accurate MS-DRG assignment, risk of mortality and severity of illness; and (b) initiate a review worksheet...

includes review of the work of others that perform service delivery of delegated patient programs and providing feedback... participation in external audits of CCM, PHM, and MOC programs, monitoring policies and procedures, and preparation and review...

to work for our teammates. As a DaVita Integrated Kidney Care Registered Nurse (RN) Case Manager you will support... some of our most complex patients, assisting them in navigating a challenging healthcare system. Through medical record review and consultation...

. Job Description: Schedule: FT, M-F, business hours (hybrid/remote option) BILHPN has oversight of population health and is responsible... and evaluates options and services to meet the individual patient needs. This role is a hybrid position. The Care Manager works...