FEATURED JOBS
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…appropriateness of current level of treatment, corresponding with LOCADTR and utilization review instruments + Coordinate integrated services with medical,
…Medicare, Medicaid, and other third party payers. Maintain a strong relationship with Utilization Review on Bed control functions to ensure process accuracy.
…service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets CMS
…with one of the most respected healthcare organizations in the world. As a Utilization Management (UM) Registered Nurse (RN) Reviewer NE PRN, you will play a vital
…Enters pertinent approval and denial information into the appropriate computer programs for Utilization Management team members to review and address in a timely
… activities and functions are handled in accordance with state specific peer review protections. + 5. Coordinate utilization of the Practitioner Excellence
…leadership team and is responsible for * Leadership and counsel for utilization management* Leadership and participation in case management programs for mental
…for the department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource use,
…engagement, ie, peer-to-peer accountability. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource
…Home Modifications, PERS and Specialized Medical Equipment services and regular review and follow-up of Technology Solutions plans to assure ongoing effectiveness.