To support a centralized Utilization Management department, the full-time Utilization Review Nurse will conduct timely utilization review activities, ensuring appropriate patient status determinations and compliance with regulatory requirements while working remotely. Key responsibilities: Conduct medical necessity reviews and patient status determinations using approved clinical criteria and organizational policies Manage payer authorization processes to promote timely approvals and reduce financial risk Collaborate with interdisciplinary teams to support appropriate patient progression and discharge planning Required qualifications: Registered Nurse license is required Bachelor's degree is required 2+ years of Acute Hospital Care experience is required Experience with Interqual and MCG is preferred Previous Utilization Management, Appeals, or Denials Management experience is preferred
...to name a few. We have an excellent reputation with the clients. Currently, we are looking for entry-level software programmers, IT enthusiasts, Python/Java developers, Data analysts/Data Scientists. Who Should Apply: Recent IT graduates looking to make their...
...Additionally, the hospitals medical office building houses offices for specialists in primary care, cardiology, obstetrics, dermatology, surgery... ..., and evaluation within the guidelines of the standards of nursing care. Responsibilities Promotes patient and family...
...Title: SAP Basis Consultant Location: Not Specified Employment Type: Contract / C2C Duration: 6+ months MOI: Video Experience: 3 4 Years (Intermediate) / 5+ Years (Advanced) Job Description We are seeking an experienced SAP Basis...
Job Description Job Description CEOposition coming soon in theCentral Kentucky Area Must have knowledge of industry regulations on the federal level
...approved COVID-19 vaccination, as well as any subsequent booster doses, as recommended by the Centers for Disease Control and Prevention (CDC). To facilitate and further encourage COVID-19 vaccinations, Stellar periodically organizes onsite vaccination clinics at its various...