Nurse Consultant Utilization Review - Franklin - Gallagher

The Manager of Utilization Review oversees a team of utilization review nurses and coordinators ensuring compliance with clinical regulatory standards enhancing the overall utilization review process to optimize patient care and manage resources effectively. · Serves as escalatio ...

Job summaryThe Manager of Utilization Review oversees a team of utilization review nurses and coordinators, ensuring compliance with clinical regulatory standards, and enhancing the overall utilization review process to optimize patient care and manage resources effectively. · ...

Job Summary · The Manager of Utilization Review oversees a team of utilization review nurses and coordinators to ensure compliance with clinical regulatory standards and optimize patient care. · ...

The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. · This role conducts admission and continued stay reviews, supports denials and ...

The Utilization Review Nurse is to assess the medical necessity and quality of healthcare services by conducting pre-service, concurrent, and retrospective utilization management reviews. · ...

+The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. · +Performs admission and continued stay reviews using evidence-based criteria, ...

The Utilization Review Nurse is to assess the medical necessity and quality of healthcare services by conducting pre-service, concurrent, and retrospective utilization management reviews. · ...

We help clients navigate complexity, support recovery and deliver outcomes that make a real difference in people's lives. · ...

Nurse Consultant Utilization Review provides utilization management review of worker's compensation claims accessing medical documentation and information provided by medical providers to determine the appropriateness of treatment setting and length of treatment required communic ...

The Utilization Review Nurse is to assess the medical necessity and quality of healthcare services by conducting pre-service, concurrent, and retrospective utilization management reviews. · ...

Registered Nurse Utilization Management is responsible for collaborating with healthcare providers and members to optimize member benefits and promote effective use of resources. · ...

The Consolidated Patient Accounts Center (CPAC) is a regionally consolidated business entity established to enhance revenue operations throughout the VHA network by standardization and consolidation of functions - and the integration of VHA and industry best standards. · The Reve ...

The Utilization Review Specialist ensures that all services provided to patients meet payer requirements for medical necessity and authorization. · Obtain initial authorizations for all new admissions · Submit concurrent reviews and continued-stay requests within required timelin ...

The Consolidated Patient Accounts Center (CPAC) is a regionally consolidated business entity established to enhance revenue operations throughout the VHA network by standardization and consolidation of functions, · English Language Proficiency. · ...

+The Clinical Director role focuses on providing clinically driven subject matter expertise with an emphasis on the AdmissionCare product. · ...

Access This Permanent Staff Utilization Review Registered Nurse Job in Columbia TN. · Join Aya for the most career options · ...

Access This Permanent Staff Utilization Review Registered Nurse Job in Columbia TN · Aya Healthcare gives you access to the most jobs — and the most exclusive opportunities — in the industry whether you want to put down roots with a permanent role explore the country with a trave ...

To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation. · Develop and communicate health services team objectives. · Establish performance goals for health services staff; ensure continuous feedback re ...

The Regional Care Manager (RCM) is responsible for utilization review, care coordination, and daily care management across multiple sites and states. · Conduct clinical reviews of off-site observation, outpatient, and acute care using InterQual criteria. · Review and document con ...

The Regional Care Manager (RCM) is responsible for utilization review, care coordination, and daily care management across multiple sites and states. This role ensures accurate and timely clinical reviews of off-site care, including observation, outpatient, and acute services. · ...