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Summary:The Utilization Management Nurse is responsible for determining and managing medical necessity of acute inpatient admissions utilizing clinical criteria. This includes communication with the Physician's admitting patients to a Children's Health System of Texas (CHST) facility and collaboration with the Physician Advisor during the review process.
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Welltower, a real estate investment trust ("REIT"), owns interests in properties concentrated in major, high-growth markets in the United States, Canada and the United Kingdom, consisting of seniors housing, post-acute communities and outpatient medical properties.
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EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:I. Education: RHIT or RHIA preferred II. Experience: 1 - 3 year of Acute Inpatient Coding Experience III. Certification/Licensure: AHIMA or AAPC approved credentialIV. Software/Hardware: 3M experience required V. Other: Remote position.
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Must have active certification as a Nurse Practitioner by one of the following: - Family Nurse Practitioner (FNP) by the American Nurses Credentialing Center (ANCC) - Pediatric Nurse Practitioner Primary Care (PNP-PC or PPCNP) by the Pediatric Nursing Certification Board (PNCB) or ANCC - Pediatric Nurse Practitioner Acute Care (PNP-AC) by PNCB - Neonatal Nurse Practitioner (NNP) by NCC OR Women's Health Nurse Practitioner (WHCNP) by National Certification Corporation.
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The Utilization Management Nurse is responsible for determining and managing medical necessity of acute inpatient admissions utilizing clinical criteria. Children's Health (Dallas) is seeking a Registered Nurse (RN) Utilization Review for a nursing job in Dallas, Texas.
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Minimum Specifications Education - Advanced Practice Registered Nurse (APRN): Master's Degree in Nursing accredited through the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for - Physician Assistant: Bachelor's Degree from an accredited college or university and successful completion of an accredited Physician Assistant Program recognized by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or its predecessors.
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The RN Case Manager II - Inpatient Services performs onsite review or telephonic clinical review of inpatient admissions in an acute hospital, rehabilitation facility, LTAC or skilled nursing facility.
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Conduct medical certification review for medical necessity for acute care facility and services. Keeps current on all Federal, State and local regulatory changes that affect delivery or reimbursement of acute care services within the scope of Utilization Management.
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150 Top Places to Work in Healthcare by Becker’s Hospital Review, 2023. The flagship hospital of Methodist Health System, Methodist Dallas is a 595-bed acute care teaching and referral hospital.
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At least 1 year Utilization Review or Case Management experience preferred. Department: Utilization Review. Escalate payer problems to UM RN II or Denials Management Specialist. requesting expedited appeal, use of third party Physician Advisor, facilitation of peer to peer with CHST Physician.
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Methodist Charlton Medical Center is a 314-bed, full-service, acute care teaching hospital that serves Cedar Hill, DeSoto, Duncanville, and Lancaster in southwestern Dallas County. Methodist Charlton Medical Center is a 314-bed, full-service, acute care teaching hospital that serves Cedar Hill, DeSoto, Duncanville, and Lancaster in southwestern Dallas County.
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You will also be connected with a full support team that was rated #1 in Nursing Satisfaction by MIT Sloan Management Review. Host Healthcare is an award-winning travel healthcare company with an immediate opening for this Registered Nurse - Long Term Acute Care in McAllen , TX.
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Depth of knowledge in Structural Engineering including but not limited to: advanced structural analysis and design, assess and evaluate loads, recommend and review appropriate materials based on structural specifications.
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Construction of the new LTSCI includes renovation of a portion of the existing Acute Care Spinal Cord Injury Building to join and integrate with the new LTSCI. Construction also includes modification and realignment of the campus loop road, utility upgrades, and associated site improvements.
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Minimum one (1) year of case management and/ or utilization review in acute care or insurance related role. Prior experience with clinical review, case management, utilization review.
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acute review jobs in Dallas, TX
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