case reviews, check medical records, speak with patients and care providers regarding treatment, and respond to the plan...

: 8 hours, days Employment Type: Travel Utilization review nurses perform frequent case reviews, check medical records...

*, Audits, Audits, Care coordination, CMS: Centers for Medicare and Medicaid Services, Continued Stay Reviews, Data Abstraction...

Registered Nurse (RN) | Utilization Review Location: Glendale, CO Agency: Adelphi Healthcare Pay: $46 per hour Contract Duration: 1 Years Start Date: ASAP About the Position TravelNurseSource is working with Adelphi Healthcare to find a...

Responsibilities The George Washington University Hospital (GW Hospital) continues to be a leader in providing the highest level of quality and compassionate healthcare for the D.C. Region. U.S. News & World Report has just released the 2...

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

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

build and drive a data-powered feedback loop for engineering design reviews, leveraging cutting-edge tools like CoLab... effectiveness of AI-driven reviews Translate engineering standards into structured checklists and AI-driven validation rules...

Utilization Review (UR) Specialist is a Registered Nurse responsible for conducting thorough medical necessity reviews to assist... with determining appropriate patient class designation. The UR Specialist will perform timely and comprehensive reviews of the patient...

level of care and duration of treatment required for complex and/or escalated reviews, and providing guidance to team...., workflows). Performs utilization reviews by: following standard policies and procedures when conducting reviews of medical...

including backup support for medical necessity appeals and standard of care reviews The successful candidate would possess...

level of care and duration of treatment required for complex and/or escalated reviews, and providing guidance to team...., workflows). Performs utilization reviews by: following standard policies and procedures when conducting reviews of medical...

. Administrative & Systems Support Utilize Microsoft Office Suite and agency software platforms to track reviews and maintain project... infrastructure. Experience performing code compliance reviews and design audits. Familiarity with SharePoint, eBuilder, or similar...

care. Conducts admission reviews for Medicare, Medicaid beneficiaries, as well as private insurers and self pay patients... and retrospective clinical reviews with various payers, utilizing the appropriate guidelines as demonstrated by compliance...

and Denials*, Concurrent Review, Concurrent Review, Continued Stay Reviews, Continued Stay Reviews, Determine Medical Necessity...

for milestone reviews; meeting management and team management Define, measure, and report key performance indicators, including...

Review*, Concurrent Review*, Continued Stay Reviews*, Continued Stay Reviews*, CPT (Current Procedural Terminology) coding...

Review*, Concurrent Review*, Continued Stay Reviews*, Continued Stay Reviews*, CPT (Current Procedural Terminology) coding...

Responsibilities: Perform medical necessity and utilization reviews for acute, sub-acute, and rehabilitation services...

& Compliance Reviews Data Abstraction and Reporting HIPAA Compliance Joint Commission Readiness and Accreditation Preparation...