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Utilization Review Specialist/Behavioral Health Substance Abuse FLSA Status : Exempt Classification: Full-Time Reports To: The UR Specialist will report to UR Manager. The Utilization Review Specialist will also perform pre-certification reviews, concurrent reviews and will perform appeal reviews as needed.
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The RN Utilization Review Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. CHRISTUS Santa Rosa Hospital - Westover Hills (CSRH-WH) is a 150-bed hospital serving the fastest growing area of San Antonio.
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The Utilization Management Nurse will be responsible for ensuring the delivery of efficient and effective health care while evaluating the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provision of the applicable health benefits plan.
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Christiana Care includes an extensive network of outpatient services, home health care, urgent care centers, three hospitals (1,336 beds), a free-standing emergency department, a Level I trauma center, a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women’s health.
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The Utilization Management Nurse will work closely with ED providers to review medical necessity and collaborate for discharge planning, as appropriate. Serves as a resource to nursing and ancillary staff, providing education on utilization review processes as needed.
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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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Must have extensive contact with: Medical Staff, Nursing Personnel, DME Providers, Home Health Agencies, Community Agencies, referral resource providers, Utilization Review Manager, patients, and family members.
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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. MedPro Healthcare Staffing is a Joint Commission certified provider of temporary and contract staffing services.
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MedPro Healthcare Staffing is a Joint Commission certified provider of contract staffing services. Work is administered in a variety of settings, including HMOs, community health organizations, long-term care facilities, behavioral health programs, rehabilitation centers, schools, and case management companies.
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Job Description UTILIZATION REVIEW / CASE MANAGEMENT RN - Part Time, Weekends. Position Summary: Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information.
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3 RN Case Managers, 1 Social Worker, 1 Lead Case Manager, 1 Case Manager assistant and 1 Utilization Review Nurse. Utilization Review RN's. 3 RN Case Managers, 1 Social Worker, 1 Lead Case Manager, 1 Case Manager assistant and 1 Utilization Review Nurse.
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Ensure that the proper treatment is administered at the appropriate time in order to maximize health and well-being. Group Health insurance for you and your family. MedPro Healthcare Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Oklahoma City, Oklahoma.
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The LVN Discharge Planner performs utilization review by using criteria that demonstrates medical necessity to achieve reimbursement for services and ensuring appropriate utilization of hospital resources.
$28.81 - $47.53 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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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. Case Manager (RN) - Utilization Management - Weekend Incentive Program (WIP.
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Provides intensive home visitation services with the provision of the Healthy Start Prenatal and Infant Pathways, and Inter-conception Care Counseling, and utilization of screening tools to identify specific risk factors including maternal depression, domestic/intimate partner violence, tobacco use, substance use, and infant development.
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health services utilization review jobs Company: Humana Inc in Wailuku, Hawaii
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