Care Career is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers, Florida. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 09/06/2026 Duration: 1 weeks 36 hou...

Care Career is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers, Florida. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 h...

of MCG and Utilization Review requirements for concurrent and initial reviews Utilization review, Case management... equipment for chart reviews Performs inpatient and observation utilization reviews Reviews medical necessity using clinical...

: Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource consumption.... Enters clinical reviews into the software program. Maintains close communication with external reviewers/internal financial...

clinical information. Responsibilities Include: Reviews the medical record by applying utilization review criteria..., to assess clinical, financial, and resource consumption. Enters clinical reviews into the software program. Maintains close...

. Documentation and Reporting: Document findings from utilization reviews in the appropriate systems and ensure accurate record...

Responsibilities The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with in 1979, the Valley Health System has grown to include , , Benefit Highl...

, and tailor response mechanisms. Ensure client expectations are met through regular performance reviews, dashboard updates...

claims through email and phone support. Conduct Dealer Self-Reviews (DSRs), document findings, and communicate results...

and tracking data from various insurance providers and health plans regarding authorization, expedited reviews and appeals...

interpretation. Monitors and controls backlog and workflow of claims. Performs clinical/medical reviews of retrospective medical... claim reviews, medical claims and previously denied cases, in which an appeal has been submitted, to ensure medical...

manner. The UR Coordinator conducts clinical reviews using established medical necessity criteria to support accurate patient... acute care medical necessity criteria. 4. Completes and submits all initial, concurrent, and discharge reviews, including...

to conduct medical record reviews and to apply sound clinical judgment to claim payment decisions. Responsibilities may include...

decision and reasoning. Reviews use of proceeds, orders SBA Number, prepares SBA Loan Authorization and other SBA forms... and is responsible for ensuring the loan meets all SBA/USDA requirements. Reviews all reports and information received with respect...

GENERAL DUTIES / RESPONSIBILITIES: 1. Performs reviews of inpatients with complex medical and social problems. 2. Generates... physician. 3. Performs follow-up reviews and evaluations of patients in the ambulatory care or lower level of care setting. 4...

: Experienced software professionals to perform manual code reviews of AI-generated code for a leading Client. This role is focused... software engineering organizations where rigorous pull request (PR) reviews, coding standards, and collaborative development...

to ensure timely permit processing and consistent decision-making. Reviews and signs off on complex or high-profile development...

field and in an office setting. The Program Manager conducts site visits scheduled and unannounced and performs desk reviews... processes. They will also be expected to participate in RFP proposal reviews as necessary by the agency COMMUNITY COORDINATOR...

at required productivity levels equivalent of 8 completed 485 review or 10 completed OASIS Reviews per day for FT employees). Extract clinical...

reviews. The employee communicates with physician and case managers regarding payor approval/denial of admission and continues... stay review. They process payor denials and retro reviews, promote optimal health care outcomes in accordance with the...