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They will perform a rigorous chart review and extract clinical and pathological information from the electronic medical record (EMR) system: EPIC and Co-Path. Students will have one mentor: Dr. Lammle, principal investigator (Department of Neuroradiology) and will have the opportunity for exposure to state of the art retrospective and clinical research.
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The Utilization Review Specialist will also coordinate with appropriate discharge planning processes, providing feedback on documentation processes; and functions as a resource to the clinical team regarding approved criteria, practice guidelines and alternative treatment options.
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The Consultant Pharmacist IV will assist in the development and management of the MassHealth Drug List, clinical initiatives, Accountable Care Organization pharmacy oversight and other pharmacy programs.
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Matrix Providers is hiring Licensed Clinical Social Workers (LCSW/LICSW/LISW) to join our team of talented professionals who provide health care services to our U.S. Military and their families at the Naval Hospital Camp Pendleton located in Oceanside, CA.
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Collaborates with the Trauma Program Manager, Trauma Medical Director, and other hospital personnel to evaluate and problem-solve variations in care identified during chart review. In conjunction with the Trauma Program Manager, the Trauma Performance Improvement RN monitors the clinical processes and outcomes and systems issues related to the quality of care provided; develops quality filters, audits and case reviews; identifies trends, near misses and sentinel events; helps to outline remedial actions while maintaining confidentiality.
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Experience providing scientific support for the development and implementation of cell therapy studies, including protocol and ICF development, electronic data capture database development, safety assessment, IB/DSUR submissions, and clinical data review.
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The Clinical Appeals Nurse will review each case identified/referred for appeal based on Milliman Care Guidelines (MCG), InterQual, and/or other relevant guidelines, determined the viability of the appeal, and manage the appeal process.
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You have a strong knowledge and practical experiences with high density data types in a clinical setting (genomics, transcriptomics, proteomics, flow cytometry, TCR sequencing, immune assays, etc.
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Communicates with physicians to ensure that correct clinical data is documented to gain proper pre-authorization for third party payers. JOB SUMMARYThe RN Utilization Review coordinates care for OPIS patients who are high cost, complex, and at risk.
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You will explore applications of generative AI and other novel technologies to clinical data and biomarker analysis across clinical development programs. You will work seamlessly with colleagues from Translational Research and Clinical Development to translate questions into data requirements, computational workflows, and intuitive summaries/visualizations.
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NCH is transforming into an Advanced Community Healthcare System(TM) and we’re proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan.
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Review medical records for knowledge/understanding of situation and resource assessment. · Assists with data analysis and report preparation to track payer mix and reimbursement. Participates in staff meetings, clinical team meetings and other meetings as necessary to support goals and outcomes.
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Communicates to clinical staff when pre-authorizations are obtained so that appointments can be made in timely to meet patient needs. Documentation and data is concise and timely. Maintains understanding of various payers and Medicare pre-authorization processes.
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Serves as a liaison between hospital and payer to obtain pre-authorization confirmation and enters into medical record/billing system timely and accurately. Understands the legal/regulatory requirements related to the release of information.
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Licensed as a Registered Nurse (RN) in the State of Florida · Minimum of 1 year of experience in a related field required. Makes referrals to the Case Manager of compassion drug program as appropriate.
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clinical data review jobs Title: clinical scientist Company: Johnson Johnson
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