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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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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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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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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.
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Ensures compliance with principles of utilization review, hospital policies and external regulatory agencies, Peer Review Organization (PRO), Joint Commission, and payer defined criteria for eligibility.
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During this individual supervision a chart review should be completed using the updated Utilization Review sheet with particular attention paid to whether or not a PGP exists to cover the time period since the last CBH review.
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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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VNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job in Hoboken, New Jersey. Posted job title: Rn Utilization Review, Clinical.
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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.
$52.46 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Registered Nurse, RN or Licensed Practical Nurse. Experience as an MDS Nurse. Assesses resident through physical assessment, interview and chart review. Are you an experienced nurse who wants to remain clinically involved in patient care without being a bedside nurse.
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Utilization RN - Utilization Review RN - Travel Utilization Review RN, Part-Time, Contract, Travel, Temporary, 13 Weeks, Temp. Tier5, Travel Utilization Review RN Registered Nurse.
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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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Attend and/or participate in facility meetings as directed by the center manager (may include utilization review, infection control, disaster preparedness, etc.) Throughout the country we operate primarily as Select Physical Therapy, NovaCare Rehabilitation, Physio, Kessler Rehabilitation Center, KORT, Saco Bay Physical Therapy, Concentra, SSM Physical Therapy and Keystone Physical Therapy.
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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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management utilization review nurse continuing jobs Title: rn Company: Medical Solutions in AZ, Australia
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