- Centene Corporation (Madison, WI)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- Centene Corporation (Sacramento, CA)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... position that requires a CA RN Licensure.** **Position Purpose** : Performs concurrent reviews, including determining member's overall health, reviewing the type of… more
- InnovaCare (San Juan, PR)
- …customer focus to the business. MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the ... compliance with the Plan's SNP policies and MOC requirements. Clinical staff who do not complete the required annual...within forty-eight (48) hours of having performed the first concurrent review of notified admission cases.4. On… more
- HCA Healthcare (Nashville, TN)
- …environment where diversity and inclusion thrive? Submit your application for our CDI Concurrent Review and Query Specialist opening with HCA Healthcare today ... may vary by location._** We are seeking a(an) CDI Concurrent Review and Query Specialist for our...to physicians for conflicting, imprecise, incomplete, illegible, or inconsistent clinical documentation. This individual need to function in a… more
- HCA Healthcare (Nashville, TN)
- …colleagues invested over 156,000 hours volunteering in our communities. As a(an) CDI Concurrent Review and Query Specialist with Work from Home you can ... you need to succeed in our organization. We are looking for an enthusiastic CDI Concurrent Review and Query Specialist to help us reach our goals. Unlock your… more
- Trinity Health (Fresno, CA)
- …current knowledge of clinical indicators and compliance requirements, conducting concurrent medical record review to ensure documentation compliance and ... position offers vital support for improvement of quality and clinical performance. This position collaborates with clinical ...field is preferred. 2. Current licensure as a Registered Nurse in the State of California is required. 3.… more
- Actalent (Atlanta, GA)
- …details if applicable. Qualifications: + Active RN License + Prior Utilization management/ Concurrent review experience + Experience with MCG Why Actalent? + ... Actalent is currently hiring for Remote Utilization Review RNs! Job Description: + Reviewing authorization requests + Utilizing evidence-based criteria and making a… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring the ... receives and reviews notification of emergent hospital admissions, completes inpatient concurrent review , establishes discharge plans, coordinates transitions of… more
- Geisinger (Danville, PA)
- …provided. The core of the program uses highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to be coded ... Job Summary The Clinical Documentation Improvement Program (CDI) is designed to...mortality, severity of illness; and initiate documentation of the review . + Pursues a subsequent review of… more
- UPMC (Hanover, PA)
- …delays in discharge. Documents all Avoidable Days in CANOPY system. + Performs clinical review on admission and/or continued stay using InterQual criteria to ... **UPMC is hiring a Professional Care Manager to support the Utilization Review process! This is a full time, day shift position with a rotating weekend and holiday… more