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Possess two (2) years of full-time broad based registered nurse experience in a utilization management review or a case management setting within the preceding five (5) years.
$59,000 - $97,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Clinical criteria, Utilization review, Prior authorization, Utilization management, Concurrent review, Interqual, RN, LCSW, Managed Care, Clinical review, Milliman, MCG, prior authorizations, DME.
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Minimum three years progressive professional experience in health care, including a minimum of two years in a grievance and appeals or related area such as medical or utilization management required.
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Reporting to the Nurse Director, RN Manager, and Charge Nurse, the Subacute Registered Nurse Days will become responsible for the assessment, diagnosis, planning, implementation, and evaluation of the care plan for assigned SNF patients.
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Registered Health Information Administrator (RHIA) OR Certified Coding Specialist (CCS) OR Registered Health Information Technician (RHIT) OR Certified Professional Coder (CPC) OR Certified Professional Coder-Hospital (CPC-H) OR Registered Nurse (RN) with education and experiential training in Medical Coding, Utilization Review, Denial Management, Case Management or related functions.
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Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator.
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Knowledge and experience with SAMSHA regulations, DPH, Joint Commission, Utilization management Detoxification requirements, Core measures, and psychiatric experience with the adult, child and adolescent and TBI and Rehab populations.
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Experience working in a Psychiatric Hospital Inpatient and/or Outpatient setting preferred) Previous Experience within the Integrated Collaborative Care Model Approach Experience with chronic condition management, particularly Diabetes, HIV, Heart Disease Pharmacy, Psyckes, E-Paces, LOCADTR, InterQual, Guiding Principles, HCS (UAS) MAPP, Medical Background & Bilingual preferred Previous Quality Management liaison experience with hospitals and other large volume providers to address cost.
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Examples may include: Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory Therapist. Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and educational needs to address established policies and procedures and job responsibilities.
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Report directly to the Administrator, Executive Director or Patient Care Manager Senior and will maintain primary control and professional management of each patient. Wellness Program and Resources including: A dedicated Accolade Care Coordinator for personalized care management support of all your healthcare needs Telemedicine Program Type 2 Diabetes Management Program via Virta Health A complete Joint and Spine Program with concierge services via Nimble Orthopedics.
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UTILIZATION REVIEW / CASE MANAGEMENT RN - Part Time, Weekends. BSN's from CCNE accredited schools Maryland Registered Nurse License American Heart Association CPR Certification.
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The MDS Coordinator supervises the Care Management Nurse, MDS Nurse. Registered Nurse (RN) or Licensed Practical Nurse (LPN) licensure. Ciena Healthcare is Michigan's largest provider of skilled nursing and rehabilitation care services.
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Keywords: Registered Nurse, RN, DON, Director of Nursing #INDMG #ZR. Participates in Pharmacy, Therapeutic, and Strategic Initiatives, Patient Safety/Sentinel Event Committee, Performance Improvement, Electronic Medical Records (EMR), Utilization Management and other process improvement committees/initiatives as directed or assigned.
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Why join the Prestige Care Family in the Resident Care Manager (RN) – MDS Nurse role and what can we offer you? What does the Resident Care Manager (RN) – MDS Nurse do.
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Job Summary: The Director of Case Management directs the Case Management and Utilization Management activities in a Kindred hospital. QualificationsEducation:Graduate of an accredited program required:RN or BSN preferred; or Masters of Social Work with licensure as required by state regulations; or Master’s degree in healthcare administration, business administration, or clinical specialtyLicenses/Certification:Healthcare professional licensure required as Registered Nurse, Licensed Clinical Social Worker (LCSW),or Licensed Social Worker (LSW), as required by state.
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registered nurse care utilization management jobs Title: registered nurse case manager Company: Sunrise Hospital
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