Overview. As a Utilization Review Nurse, you will work under the direct supervision of the Supervisor, Utilization Review and Clinical Documentation Improvement, this role will be responsible for providing clinically based concurrent and retrospective review of inpatient medical records to evaluate the documentation and utilization of acute care services. This includes facilitation of appropriate physician documentation of care to accurately refl...
Job Summary. At Gritman, we pride ourselves on being the premier healthcare employer on the Palouse. We bring exceptional care that’s close to home for the members of our community, We are seeking a Staff RN to join our Utilization Review/Case Management team. The Utilization Review Nurse (UR) has skills in areas of Utilization Management (UM), medical necessity and patient status determination. This includes examining medical records, treatment ...
Job Summary. At Gritman, we pride ourselves on being the premier healthcare employer on the Palouse. We bring exceptional care that’s close to home for the members of our community, We are seeking a Staff RN to join our Utilization Review/Case Management team. The Utilization Review Nurse (UR) has skills in areas of Utilization Management (UM), medical necessity and patient status determination. This includes examining medical records, treatment ...
Overview. Performs clinical review of patient records to evaluate the utilization of acute care services. Communicates to third party payors to support the medical necessity of the hospital admission for services reimbursement. Ensures the patient care team is aware of general length of stay requirements for all patients. Facilitates physician documentation through concurrent interaction with physicians to support reimbursement and clinical sever...
The role of the Utilization Review Nurse actively supports the management of a successful compliant utilization review program through planning, process evaluation, data analysis and establishing goals to obtain entitled reimbursement and comply with regulatory and third party payer utilization guidelines. Seeks and implements methods to effectively streamline appropriate information sharing with payers and other customers. This role performs con...
Company Description. Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow. We’ve stayed true to our focus of findi...
Job Description. This position will be remote role for Nurses in Michigan. Should have a valid MI RN License. Should Have utilization management experience. Should have experience completing post-acute reviews for the inpatient rehab, skilled nursing facility settings previously. The candidate should be well versed in coordination of care activities along with discharge planning which is a plus for this role in ensuring members are transitioned s...
Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others,...
Mountain View Hospital is looking for a Case Manager/Utilization Review to join our team. JOB SUMMARY. Performs utilization review activities in accordance with all state and federal mandated regulations in order to evaluate the necessity, appropriateness and efficiency of medical services provided. Maintains compliancy with regulation changes affecting utilization review and case management. Reviews patient’s records assists in evaluating patien...
About Us. HEALING THE BODY AND MIND. . Founded fifteen (15) years ago, NeuroPsychiatric Hospital is the largest hospital system in the nation providing care to patients with both neurological and medical needs. We are unique in that we serve a population which others have been previously been unable to, largely due the patient’s underlying medial issues. Our facilities maintain an inter-disciplinary focus using a multi-specialty approach for bo...
Overview. This position reviews services to patients of all ages to ensure appropriate status of admission, length of stay and utilization of criteria based Severity of Illness/Intensity of Service. Utilizes clinical and nursing knowledge of documentation requirements to improve overall quality and completeness of clinical documentation of patient records. Qualifications. Nurse with current Illinois RN or LPN license. Five years experience in cl...
Overview. Utilization Review Nurse. . Berkshire Hathaway GUARD Insurance Companies, an A Superior rated Insurance company is seeking a Utilization Review Nurse who is interested in joining a company with a unique culture dedicated to technology and customer service. Become part of our dynamic, growing managed care specialist team. . Berkshire Hathaway GUARD. offers a collaborative company culture with outstanding benefits and competitive compensa...
