MSA Nurse Reviewer - Woburn

We are seeking Medical Analysts with experience in preparing Medicare Set Asides and Medical Cost Projections. · Through a review of relevant medical files and related documentation, provides a narrative and cost projection for future treatment related to Workers Compensation and ...

We are seeking Medical Analysts with experience in preparing Medicare Set Asides and Medical Cost Projections. This includes reviewing records, preparing the narrative and an appropriate allocation for medical treatment and prescription medications. · Candidates will demonstrate ...

We are seeking a talented individual for a Nurse Reviewer (RN) to support our Massachusetts contract. This role involves performing clinical reviews to determine if the medical record documentation supports the need for the service based on clinical criteria, coverage policies, a ...

Discharge planning educate providers on utilization and medical management provide clinical knowledge perform onsite review of emergent urgent and continued stay requests. · ...

+Job summary · The UMCM will utilize clinical knowledge to analyze, assess, · and render approval decisions,+Review authorization requests for medical services, · including making initial eligibility and coverage determinations, · ...

Solomon Page is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Everett, Washington. · Specialty: Utilization Review · ...

+The Preservice Review Nurse RN is responsible for evaluating the appropriateness of inpatient and outpatient services based on medical guidelines and benefit determination. · +Determine the appropriateness of inpatient and outpatient services following evaluation of medical guid ...

The Preservice Review Nurse RN is responsible for evaluating the appropriateness of inpatient and outpatient services based on medical guidelines and benefit determination, identifying solutions to non-standard requests and problems, and collaborating with leadership and team mem ...

LanceSoft is seeking a travel nurse RN Case Management for a travel nursing job in Everett. · ...

We believe that no one should have to navigate the cost and complexity of healthcare alone, · and we're on a mission to make healthcare simpler and more effective for our millions of members.The Pre-Certification Review Nurse – Pharmacy is responsible for reviewing and processing ...

Bestica is seeking a travel nurse RN for a utilization review job in Everett, Washington. · ...

We are seeking a travel nurse for a 13-week assignment in Everett, Washington. · Current Washington licenseExcellent interpersonal skills including patience empathy and compassionEffective communication skills including active listening writing speaking reading comprehensionFast ...

We believe that no one should have to navigate the cost and complexity of healthcare alone, and we're on a mission to make healthcare simpler and more effective for our millions of members. · ...

LanceSoft is seeking a travel nurse RN Case Management for a travel nursing job in Everett, Washington. · Case management experience required · ...

We seek an Inpatient Behavioral Health Admission Review Nurse to become a valued member of our team at Veterans Inc. · Patient Assessment: Conducting initial assessments of patients to determine their need for inpatient care. · Information Gathering: Collecting medical histories, ...

The Nurse Manager for Utilization Review and Clinical Appeal Management oversees daily operations of UM and Appeal teams ensuring compliance with hospital policies regulatory requirements payer guidelines. This role supports efficient effective utilization review denial managemen ...

The Nurse Manager oversees daily operations of Utilization Management (UM) and Clinical Appeal teams. · Collaborates with interdisciplinary teams to reduce payer denials.Provides leadership, staff training, and quality improvement initiatives. ...

The Nurse Manager for Utilization Review and Clinical Appeal Management is responsible for overseeing the daily operations of the Utilization Management (UM) and Clinical Appeal teams. · ...

The Nurse Manager oversees daily operations of Utilization Management UM and Clinical Appeal teams ensuring compliance with hospital policies regulatory requirements payer guidelines supporting efficient effective utilization review denial management processes collaborating inter ...

Make a difference every day as an Amedisys nurse practitionerJoin Amedisys-one of the largest and most trusted home health and hospice companies in the U.S.-where flexibility, purpose and growth come together to help patients heal where they feel most comfortable, at home. · ...