RN Utilization Review

Conducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's degree...

Job SummaryAs a Utilization Review Nurse at Medstar, you will play a crucial role in ensuring high-quality patient care while maintaining efficiency. Your primary responsibility will be to conduct admission, concurrent, and retrospective case reviews to verify the appropriateness of patient care and level of treatment. You will collaborate with medical staff...

Conducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's degree...

General Summary of PositionUnder the direction of The Director of UM/Appeals assists in the administration of utilization functions, the Utilization Review Nurse, assesses patient insurance/status to facilitate appropriate completion of utilization review using payer specific criteria; uses Interqual and MCG to determine medical necessity and appropriateness...

Conducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's degree...

Conducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's degree...

Conducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way. Education Associate's degree in Nursing required Bachelor's...

Conducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's degree...

Conducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way. Education Associate's degree in Nursing required ...

General Summary of PositionConducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way. Primary Duties and...

Conducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's degree...

Job SummaryWe are seeking a skilled Clinical Utilization Review Specialist to join our team at Lexington Medical Center. As a key member of our Utilization Management Department, you will play a critical role in ensuring the quality and efficiency of our patient care services.Key ResponsibilitiesPerform admission and concurrent stay medical record reviews to...

Conducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way. Education Associate's degree in Nursing required Bachelor's...

Conducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's degree...

Conducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's degree...

Conducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.EducationAssociate's degree in Nursing required Bachelor's...

Great Hill Solutions is part of the Seneca Nation Group (SNG) portfolio of companies. SNG is the federal government contracting business wholly owned by the Seneca Nation. SNG meets mission-critical needs of federal civilian, defense, and intelligence community customers across a variety of domains. The SNG portfolio receives shared services support from its...

Job DescriptionJob DescriptionDescriptionThe Clinical Review Specialist is responsible for proper clinical review and interpretation of medical records and claim documentation to assist with the appeals of denied insurance claims. Responsibilities include drafting appeal letters based on clinical judgment and knowledge. This is a remote position with the...

Job Title: Medical Nurse ReviewerGreat Hill Solutions, part of the Seneca Nation Group portfolio, is seeking 3 Medical Nurse Reviewers to support our Dept. of State contract. The position is remote, but the chosen candidate must be willing to work ET hours.Job Summary:The Medical Nurse Reviewer position is located in the SCA/CARE Office and is responsible...

Major purpose of this job: The Accreditation Reviewer is an expert in the content and interpretation of accreditation programs and standards. Primary responsibilities include analyzing accreditation application documentation and conducting validation reviews. Key additional responsibilities include participating in the standards development/revision process,...