Utilizing a collaborative process, the CM will assess, plan, implement, monitor & evaluate the options/services required to meet a patients health needs, using good communication & available resources to promote quality, cost effective outcomes to 18-22 pts on the Menino Campus. The CM will meet patients needs, manage the LOS & promote efficient utilization of resources. Determines medical necessity & appropriateness of admission w/InterQual scre...
Job Details. Job Location. MO, St. Louis - Missouri Corporate Office - St. Louis, MO. Position Type. Full-Time. Education Level. Associate's Degree. Salary Range. Undisclosed. Job Shift. Day. Job Category. Nursing Professional & Support. Description. We are currently seeking a. full-time Utilization Review Nurse. to join our. St. Louis Corporate Team. . . The. Utilization (UM) Nurse. performs the review of requests for prior authorization of medi...
Why Choose Jefferson Health Plans. We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We are committed to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential. While this job cur...
Why Choose Jefferson Health Plans. We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We are committed to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential. While this job cur...
Why Choose Jefferson Health Plans. We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We are committed to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential. While this job cur...
Why Choose Jefferson Health Plans. We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We are committed to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential. While this job cur...
Position Overview. The. Utilization Review Nurse. is responsible for coordinating all components of the utilization review process, which includes timely review of treatment requests for medical necessity, ensuring appropriate cost-effective treatment and promotion of best patient outcomes. The. Utilization Review Nurse. performs the initial clinical review, prepares an organized case summary and may issue certifications of medical necessity. Whe...
Job Details. Job Location. MO, Jefferson City - Missouri Regional Office - JEFFERSON CITY, MO. Position Type. Per Diem. Education Level. Associate's Degree. Salary Range. Undisclosed. Travel Percentage. None. Job Shift. As Needed. Job Category. Nursing Professional & Support. Description. Centurion is proud to be the provider of comprehensive healthcare services to the Missouri Department of Corrections. We are currently seeking a. PRN. Utilizati...
Why Choose Jefferson Health Plans. We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We are committed to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential. While this job cur...
The Utilization Management (UM) Nurse is a licensed nursing professional responsible for reviewing UM cases and discharge planning activities. The UM Nurse may also assist with preparing files for audits and required reporting and ensuring UM cases are reviewed and processed within timeliness standards. The UM Nurse will work closely with the UM/QI Manager, MSO UM team, MSO Medical Director, and MSO Physician Reviewer on UM case reviews. The UM N...
