Description The Utilization Review (UR) Nurse has a strong clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports...

Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Providence caregivers are not simply valued – they’re inval...

Description The RN Case Manager is responsible for carrying out effective case management functions for identified patients by planning, coordinating, negotiating, procuring and managing the care and needs of complex patients and their fa...

Hospitals on Incredible Health are actively hiring and accepting applications in the Jackson, MI area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encou...

Hospitals on Incredible Health are actively hiring and accepting applications in the Jackson, MI area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encou...

Hospitals on Incredible Health are actively hiring and accepting applications in the Jackson, MI area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encou...

Hospitals on Incredible Health are actively hiring and accepting applications in the Jackson, MI area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encou...

Hospitals on Incredible Health are actively hiring and accepting applications in the Jackson, MI area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encou...

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on ...

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

product/process improvements Support Integrated Product Teams (IPT) and participate in design reviews Represent the...

clinicians to support Applied Behavior Analysis (ABA) clinical reviews and authorization assessments. Resources... reauthorizations, clinical reviews, and appeals as applicable Ensure documentation is complete, compliant, and audit ready...

and medical necessity reviews of prior authorization requests in accordance with established guidelines and criteria Evaluate... in Prior Authorization (PA) or Inpatient (IP) reviews within an insurance/health plan environment Active LPN license...

clinicians to support Applied Behavior Analysis (ABA) clinical reviews and authorization assessments. Resources... reauthorizations, clinical reviews, and appeals as applicable Ensure documentation is complete, compliant, and audit ready...

Summary of Position Perform clinical reviews within the Medical Management Operations Concurrent Review utilization... appropriate clinical reviews and patient care. Enter and maintain documentation in the TPH platform meeting defined timeframes...

clinical reviews and denial appeals where appropriate either during admission or post discharge. Providence caregivers...

managing all aspects of credit risk reviews. The position requires a self-driven, problem solving individual... that has a strong credit review background. Responsibilities Lead target reviews, continuous monitoring reviews and risk assessments...

. This is a position in the Land Use Review division, which reviews and provides case management services for and from initial submission...

each stage and PMRC approval process. Reviews final production proofs provided by Commercial, conducts some functional reviews...

. This position reviews both capital and private development projects for conformance with adopted codes and statutes. Essential... Duties: Reviews, processes, and approves private development engineering plans, reports, model outputs...