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The Utilization Management Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. The Utilization Management Nurse III is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services.
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ScionHealth - Kindred Cornerstone & Solara Hospitals is seeking a Registered Nurse (RN) Case Management Director for a nursing job in Hawthorne, California. directs the Case Management and Utilization Management activities in a Kindred hospital.
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The Care Management Nurse, MDS Nurse works the RAI process and conducts assessments and care plan coordination for those residents assigned. 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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The Utilization Review Specialist manages daily operations, which include supervising the staff performing benefit enrollments and utilization management activities. The Utilization Review Specialist review functions as the internal resource on issues related to the appropriate utilization of resources & services, coordination of care across agency and utilization review and management.
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The Case Management process facilitates communication and care coordination along a continuum through effective transitional care management and utilization management. 2 years of experience in Case Management (Care Coordination or Utilization Management) or successful completion of the Transitions in Practice (TIP) program for Care Manager.
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Registered Nurse, RN or Licensed Practical Nurse. Experience as an MDS Nurse. Are you an experienced nurse who wants to remain clinically involved in patient care without being a bedside nurse.
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Utilization Review RN Case Management. As a Utilization Review Nurse/Integrated Care Manager RN with Sentara, you work together intensely with the patients, families, and members of the medical team to provide patients with the resources they need and help prevent them from being readmitted to the hospital.
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Registered Nurse (RN) licensure or Licensed Practical Nurse (LPN). Are you an experienced MDS nurse interested in the next step? Ciena Healthcare is a national provider of skilled nursing, subacute, rehabilitative, and assisted living services dedicated to achieving the highest standards of care.
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It is also expected that the Psychiatric Nurse Practitioner will act as a liaison between Polara and community physicians/providers, consult with non-medical Staff members of Polara clinical staff, and participate in the development and operation of various Polara programs, quality improvement efforts, and utilization management projects.
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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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Partners with the UM Chief and KFH/TPMG local medical center leadership, to engage the following areas in the development and implementation of a comprehensive utilization management work plan to meet or exceed medical center targets: Physicians, managers across the continuum, and TPMG/KFH service leaders and managers.
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Current working knowledge of discharge planning, utilization management, case management, performance improvement, disease or population management and managed care reimbursement.
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Avosys is seeking a Registered Nurse in Utilization Management to provide outpatient services to the military and their families. projects with consideration for the goals and objectives of the MTF’s Utilization Management and Medical.
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Works in conjunction with Physician offices, Case Management, Utilization Review, and patients to obtain supporting clinical data for the payer in order to obtain a pre-authorization. Under the supervision of the Utilization Review Manager, this position is responsible for ensuring the delivery of outstanding customer service in the process of obtaining pre-certification approvals from insurance companies (for both inpatients and outpatients), identifying insurance and/or patient responsibility, insurance verification, admission notifications, identifying approved days, follow up required, and providing financial counseling when appropriate.
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The MDS Coordinator supervises the Care Management Nurse, MDS Nurse. Registered Nurse (RN) licensure. Ciena Healthcare is Michigan’s largest provider of skilled nursing and rehabilitation care services.
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management utilization nurse continuing jobs Title: travel rn Company: Medical Solutions in AZ, Australia
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