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The RN Utilization Review Nurse collaborates as necessary with other members of the health care team to ensure the above is according to the mission of CHRISTUS. Job Title: Registered Nurse Utilization Review.
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IDD (Individuals with Intellectual & Developmental Disabilities) Habitational Training Services (HTS), Daily Living Support (DLS), Agency Companion and Respite, Vocational Rehab, SummaryThe Corporate Compliance Nurse is a professional, registered nurse responsible for all the quality activities of the organization and will work with area Directors, review charts of multiple sites, develop education and training tools as well as maintain the Program integrity.
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Corporate Compliance Nurse This is a corporate, enterprise-wide role, serving as a resource to our programs and senior leadership regarding issues of Compliance & QA/PI. Service lines: Home Health (skilled), Private Duty, Hospice, Palliative Care, Homecare (non-skilled / ADL) experience.
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Ability to implement and maintain audits for compliance and qualityExcellent understanding of performance improvement, quality assessment, and utilization management. Corporate Compliance Nurse is responsible for designing and implementing policies, programs, and processes to ensure the organization is compliant will all federal, state and accreditation standards, guidelines and regulations and will ensure the highest degree of quality is adhered to in the care of patients.
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An emphasis in home care/hospice nursing is preferred). Qualifications Home Health & Hospice Industry experience is mandatory. Registered Nurse10+ years in the healthcare industry in the area of Quality Assurance, Quality Improvement or ComplianceThree (3) to five (5) year's clinical nursing experience.
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Two (2) years hospice experience preferred, with a strong knowledge of hospice regulatory standards. Contributes to the fulfillment of the organization’s mission/vision by performing various audits with ongoing monitoring of essential services related to compliance with federal and state laws and regulations and identified QAPI programs.
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They will also be responsible for providing indirect patient care services primarily by performing medical record reviews according with the policies and procedures of the organization. Is self-directed and able to work with minimal supervision.
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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.
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This Nurse should have a minimum of 5 years INPATIENT clinical nursing experience in an acute care hospital setting, minimum of 2 years Utilization Management/Review in an acute care setting, Minimum of 2 yeras experience working with InterQual or Milliman in an acute care setting, and Bilingual preferred.
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Collaborates with Social Work, Utilization Review, Clinical Documentation Specialists, and others as necessary to maximize financial/care resources for patient and family. Job SummaryOur Registered Nurse Care Coordinator Case Manager coordinates discharge planning that begins at the time of admission and is reevaluated and adjusted throughout the patient’s hospital stay.
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TRS Healthcare is seeking a Registered Nurse who is licensed to work in TX, and has Utilization Review experience. Registered Nurse - Utilization Review. 1 year of recent experience specializing in Utilization Review.
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These responsibilities may include utilization review, pharmacy oversight and care coordination. Knowledge of URAC standards, ODG, Utilization review, state workers compensation guidelines.
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The Utilization Management Nurse will provide precertification of inpatient hospitalizations and all outpatient procedures and services requiring authorizations. The nurse will use clinical judgement, utilization management, application of product benefits, understanding of regulatory requirements, and verification of medical necessity utilizing nationally recognized criteria.
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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 organizations mission and values. Description: The RN Utilization Review II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services.
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This role performs telephonic and/or concurrent review of inpatient hospitalizations and extended courses of outpatient. Minimum of two years Utilization Management acute care setting experience required.
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utilization review nurse jobs in Dallas, TX
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