- CHRISTUS Health (Wake Village, TX)
- Description Summary: The Registered Nurse Clinical Care Coordinator is responsible for evaluating, coordinating, processing, screening, and documentation of ... patient entry into the CHRISTUS Health System. The Registered Nurse Clinical Care Coordinator will collaborate with relevant providers and partners to determine… more
- Eclaro (Utica, NY)
- …make medication sheet for each client that gets injections Complete clinical documentation that meets compliance standards, medical necessity guidelines, and agency ... necessary documentation Maintain spreadsheets for injections/health screens Triage client calls Review client's notes and brief relative staff Answer calls from the… more
- Elevance Health (Miami, FL)
- ** Clinical Review Nurse I - Medicare Part A & B** National Government Services is a proud member of Elevance Health's family of brands. We administer ... Friday 8 am - 5 pm EST or CST. Hours are flexible.** The ** Clinical Review Nurse I** is responsible for reviewing and making medical determinations as… more
- Hackensack Meridian Health (Little Falls, NJ)
- …educate and support appropriate documentation for coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed ... issues to the Director of the certified operation, Hospice Clinical Director, and the Nurse Manager for...clinical audits. Trend data obtained from reports and review results with managers. + Identify areas for improvement… more
- Hackensack Meridian Health (Brick, NJ)
- …educate and support appropriate documentation for coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed ... issues to the Director of the certified operation, Hospice Clinical Director, and the Nurse Manager for...clinical audits. Trend data obtained from reports and review results with managers. + Identify areas for improvement… more
- Centene Corporation (New York, NY)
- …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, ... on workplace flexibility. **Must have an active New York State clinical license.** **Position Purpose:** Analyzes all prior authorization requests to determine… more
- Centene Corporation (Madison, WI)
- …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, ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… 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, ... years of related experience. 2+ years of acute care experience required. + Clinical knowledge and ability to determine overall health of member including treatment… more
- Actalent (Atlanta, GA)
- Actalent is currently hiring for Remote Utilization Review RNs! Job Description: + Reviewing authorization requests + Utilizing evidence-based criteria and making a ... if applicable. Qualifications: + Active RN License + Prior Utilization management/Concurrent review experience + Experience with MCG Why Actalent? + Work with a… more
- System One (Baltimore, MD)
- ALTA IT Services is staffing a contract opportunity for a Clinical HEDIS Specialist support a leading health insurance customer. The main duties include conducting ... if errors are found. Correct errors identified through over-read process, including a re- review of charts that may contain similar errors. + Identify and report… more
