Concurrent Review Nurse - Linthicum Heights, MD

Job Type · Full-time · Description · Summary/Position Objectives: · The Utilization Management (UM) Nurse is responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to members. Utilizing evidence-based guidelines, regulato ...

· Description · Summary/Position Objectives: · The Utilization Management (UM) Nurse is responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to members. Utilizing evidence-based guidelines, regulatory requirements, and ...

Summary/Position Objectives: · The Utilization Management (UM) Nurse is responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to members. Utilizing evidence-based guidelines, regulatory requirements, and health plan crit ...

As a Utilization Review Registered Nurse for Johns Hopkins Health Plans, you have the opportunity to use your clinical skills to make a difference in our members' lives. · ...

Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. · ...

We are seeking an Utilization Review Nurse to facilitate and coordinate programs in hospital inpatients, outpatients, families, community, and employees by providing evidence-based care based on the nursing process. · ...

Overview: · Johns Hopkins Intrastaff is the internal staffing agency for the Johns Hopkins Health System and partner hospitals, providing temporary support to a variety of Johns Hopkins locations. Our employees are the strength of our service. Intrastaff is unique because it's on ...

Purpose · Resp & Qualifications · The Clinical Medical Review Nurse handles day-to-day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to support claims processing and/or adjud ...

This role combines clinical medical review and medical record abstraction responsibilities. The position handles day-to-day review of professional and institutional claims, provider appeals, and medical record abstraction to determine benefit eligibility and support claims proces ...

This role combines clinical medical review and medical record abstraction responsibilities. The position handles day-to-day review of professional and institutional claims, provider appeals, and medical record abstraction to determine benefit eligibility and support claims proces ...

Purpose · Resp & Qualifications · The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to support claims processing and/or adjud ...

This role combines clinical medical review and medical record abstraction responsibilities.The position handles day-to-day review of professional and institutional claims, provider appeals, and medical record abstraction to determine benefit eligibility and support claims process ...

We are seeking a Medical Review Nurse for long term contract position with our customer in the Maryland area.This position assists in determining acceptable medical risk to the organization by analyzing medical information of applicants for enrollment in specific policies. · ...

+This role combines clinical medical review and medical record abstraction responsibilities. · +Claims Review & Analysis (35%): Review and analyze professional and institutional claims using critical thinking, nursing judgment, and corporate/medical policies. · ...

This role combines clinical medical review and medical record abstraction responsibilities. The position handles day-to-day review of professional and institutional claims, provider appeals, and medical record abstraction to determine benefit eligibility and support claims proces ...

Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care. · Competitive compensation (additional compensation such as overtime, shift differentials, premium pay, and bonuses may apply depending on ...

Join LifeBridge Health to advance health access and elevate patient experiences as a Utilization Review Nurse RN. · ...

A Clinical Medical Review Nurse will be reviewing medical records and extracting clinical data. · ...

Clinical medical review nurse to collect medical records and extract clinical data from provider offices in MD. · ...

The Nurse Educator/Review Coordinator's primary role is to facilitate provider education related to the claim reviews performed under Task Order 3 for the BFCC-QIO contract. · ...