- St. Luke's University Health Network (Allentown, PA)
- …communities we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party ... JOB DUTIES AND RESPONSIBILITIES: + Reviews all Inpatient Retroactive Denials in the Denials Management ...an accredited, professional nursing program. + Must have current RN license to practice in the state of Pennsylvania… more
- Trinity Health (Pontiac, MI)
- …medical record. 10 Participates in the appeal process when deemed necessary by the Denials Management Specialist on cases where payment has been denied. ... Degree in Nursing preferred . **B.** **Licensure / Certification** Current RN licensure within the State of Michigan. Certified Professional in Utilization… more
- AdventHealth (Winter Garden, FL)
- …transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the ... and understanding of medical necessity are core competencies of this role. The RN Care Manager facilitates the collaborative management of patient care across… more
- Carle (Urbana, IL)
- …Nursing required within five (5) years of start date CERTIFICATION & LICENSURE REQUIREMENTS Registered Professional Nurse ( RN ) License Illinois upon hire and ... Clinical Transition Specialist RN + Department: IP Clinical...Work Location: Carle Urbana Forum + Nursing Specialty: Case Management + Secondary Job Category: Nursing + Weekend Requirements:… more
- Cleveland Clinic (Vero Beach, FL)
- …from an accredited school of professional nursing. + Current state licensure as a Registered Nurse ( RN ). + Basic Life Support (BLS) certification through ... design and initiate special projects as supervised by the Team Manager. Utilization Management Specialist Join our team at Cleveland Clinic Indian River… more
- AdventHealth (La Grange, IL)
- …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- BayCare Health System (Clearwater, FL)
- …RN . **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager) ... **BayCare Health System** is currently seeking a **Utilization Review Specialist Senior** to join our outstanding and compassionate team....in Case Management + Preferred 3 years Registered Nurse in Critical Care or Emergency… more
- Texas Health Resources (Rockwall, TX)
- …care hospital required and * 1 year in discharge planning/care management preferred * RN - Registered Nurse required upon hire and * CPR - ... **Care Transition Manager RN - Care Management PRN Days**...to schedule follow up appointments with either a PCP, specialist , clinic, visiting physician or other transitional care visit… more
- Select Medical (West Orange, NJ)
- …authorization of referrals scheduled for admission to the acute inpatient rehabilitation hospital. + Registered Nurse ( RN ) or Licensed Practical Nurse ... and denials through TOC. **Qualifications** **Minimum Qualifications** + Licensure as a Registered Nurse or LVN/LPN is required + 2 years of direct… more
- Carle (Urbana, IL)
- …EDUCATIONAL REQUIREMENTS Associate's Degree in Nursing or Doctorate CERTIFICATION & LICENSURE REQUIREMENTS Registered Nurse ( RN ) Illinois or Registered ... Clinical Documentation Integrity Specialist + Department: Health Information Management ...peers and providers we needed or requested. Reviews DRG denials and provides information to the denials … more