RN UTILIZATION REVIEW jobs in PHILADELPHIA PA, United Kingdom

condition through the comprehensive review of medical records, including medical history and treatment documentation... medical need for services. Review treatment plans with providers for requested services, inpatient admissions, or continued...

: Hours 7a-3:30p Specialty Type: Nursing Sub Specialties: Utilization Review RN General Certifications: General... (Required) Bachelors Degree : BSN (Required) Experience 1 Year experience of recent Utilization Review in acute care or in insurance...

and medical necessity. Performs utilization review in accordance with all state mandated regulations. Consults with Physician..., preferably in area of population specialty. Experience in utilization management or review preferred. Knowledge...

with insurance companies. Negotiates and advocates for patient length of stay and level of care. Oversees utilization review...: Must possess knowledge of psychiatric care, utilization review, insurance reimbursement procedures, etc. Basic computer skills...

with insurance companies. Negotiates and advocates for patient length of stay and level of care. Oversees utilization review...: Must possess knowledge of psychiatric care, utilization review, insurance reimbursement procedures, etc. Basic computer skills...

professionals. The Case Manager performs daily utilization review and conveys pertinent telephonic information to third party payers...RN Case Manager I - Special Needs & Ambulatory Dept Philadelphia PA Full-time Industry: Healthcare / Health...

preferred.8. Excellent written, verbal and listening communication abilities.9. Prior experience in utilization review...Requisition Number 505755 Job Title Care Trans Nurse Lead RN-NLCT Location Genesis HealthCare City...

and other healthcare professionals. The Case Manager performs daily utilization review and conveys pertinent telephonic information...RN Case Manager-Philadelphia PA Overview Our client is a 188-bed facility that provides exceptional care...

The Care Management Coordinator primary responsibility is to evaluate a member’s clinical condition through the review... services determined to be medically necessary based on their personal review. For those cases that do not meet established...

or utilization management position (experience can be a combination of LVN/RN licensure) Previous HEDIS and/or CMS STARs experience... to type 35WPM Knowledge of utilization review requirements and procedures Knowledge of current health care practices...

or utilization management position (experience can be a combination of LVN/RN licensure) Previous HEDIS and/or CMS STARs experience... to type 35WPM Knowledge of utilization review requirements and procedures Knowledge of current health care practices...

. Collaborates closely with, providing oversight as needed to, the Clinical Coordinator/Charge RN or Nurse Supervisor acting as nurse... regarding access care including medical instructions. Addressing patient concerns, issues, and questions including the review...

system Validate what the customer requested and complete their design through the following methods: review (and document... auditing and review processes to ensure project goals and deliverables are met. Collaborates with analysts to define system...

. Manages costs through appropriate utilization and management of labor and supply across the wound care continuum. Works.... The CPD partners with the for review of clinical practice. As needed, serves as case manager to a group of wound care...