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Three to Five (5) years experience in Case Management/Utilization Review (as either CADC, LAADC, LCSW, LMHC, LMFT, Case Manager, or Utilization Review Coordinator.
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Key Words: RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN *Weekly payment estimates are intended for informational purposes only and include a gross estimate of hourly wages and reimbursements for meal, incidental, and housing expenses.
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Continually evaluate, monitor and improve the patient flow program effectiveness as it relates to utilization review, resource management, discharge planning and care coordination as well as coordination of efforts with the Revenue Integrity Department to monitor and prevent insurance denials.
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Qualifications Masters Degree preferred; minimum Bachelors Degree in Psychology or related Human Service Field or RN. Knowledge of Utilization Review Processes, insurance plans, mental health and chemical dependency treatment.
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The Clinical Care Coordinator – ED acts as principal liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and Health Information Management to ensure appropriate level of care is assigned, progression of care is efficient, and discharge/transition plans are executed as needed.
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Case management, utilization review, or discharge planning experience in an acute, rehabilitation, skilled nursing or outpatient setting is required. · Health plan experience in utilization review and case management will be considered.
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Under the guidance and direction of the UM department RN Manager or Director, the Utilization Management Review Nurse (LVN) performs prospective and retrospective clinical review for inpatient and outpatient authorization requests in compliance with all applicable state and federal regulatory requirements, SCFHP policies and procedures, and applicable business requirements.
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The Utilization Review Nurse is responsible for utilization review, utilization management, and quality assurance activities for assigned services/areas/patients within the Cottage Health System and will champion, engage, manage and monitor proactive communications and interventions by and between relevant stakeholders with regard to utilization review management.
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JOB PURPOSE The Utilization Review Nurse is responsible for utilization review, utilization management, and quality assurance activities for assigned services/areas/patients within the Cottage Health System and will champion, engage, manage and monitor proactive communications and interventions by and between relevant stakeholders with regard to utilization review management.
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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.
$33.3 - $44.49 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Case Manager (RN) Utilization Management Weekend Incentive Program (WIP) Weekend Shift: Saturday & Sunday (Hours: 7pm-7am) Newark, DE Christiana Care Hospital currently recruiting a Registered Nurse (RN) for our Weekend Incentive Program (WIP) with experience in Utilization Management in an Acute Care Hospital Setting.
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Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If this opportunity is your next step in your career path, we encourage you to apply for our Case Management RN PRN opening. Description IntroductionDo you have the career opportunities as a(an) Case Management RN PRN you want in your current role.
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MedPro Healthcare Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Glendale, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 10/14/2024 Duration: 13 weeks 36 hours per week Shift: 8 hours, days Employment Type: Travel MedPro Healthcare Staffing , a Joint Commission-certified staffing agency, is seeking a quality Case Manager Registered Nurse (RN) for a travel assignment with one of our top healthcare clients.
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The Utilization Management Nurse will work with ED providers to review medical necessity and collaborate for discharge planning, as appropriate. Case Manager (RN) - Utilization Management - Weekend Incentive Program (WIP.
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Assure that all Pay 4 Performance criteria are being met: The Blended Case Management Supervisor is responsible for assuring that the staff under their supervision are making every attempt to complete the documentation in a timely fashion and that it meets the general guidelines of legibility, it is signed, dated and that the content follows the DAP format and explains the nature of the contact.
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pet insurance case management utilization review jobs Company: Hca in Enfield, Connecticut
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