Table of Content
If you re looking for a fulfilling career, then it s time to join the Rivers Edge Rehabilitation and Healthcare Center team as an LPN. If you re looking for a fulfilling career, then it s time to join the King David Center for Nursing & Rehabilitation team as an LPN. LPN- Licensed Practical Nurse for Pine Acres in Madison Working at Pine Acres truly means becoming a member of our family. As an Senior Medical Economics Analyst, you will be working cross-functionally providing consultative support and medical cost based analysis of markets and network initiatives.
Work collaboratively with a team of analysts and local market leaders. Analyze and research utilization and unit cost medical costs drivers. Turn data into usable information by telling the story through data visualization. Support the development of scoreable action items by identifying outlier cost issues. Support the peer-to-peer discussion process by communicating with external physicians and providers about denial determinations. Conduct verbal and written review and appeal of denied or downgraded coverage determinations made by managed care/commercial payors.
Utilization Review Nurse Related Jobs
This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. As a Medical Economics Manager, you will provide consultative support and medical cost-based analysis of markets and network initiatives. You will be responsible for consulting with network and clinical management on opportunities to improve our...
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex... Provide medical leadership for all utilization management, pharmacy, case management, disease management, cost containment, and medical quality improvement activities.
Utilization Review Medical Director
Assesses, calculates and specifies the conditions under which the company is willing to accept risk on group life, disability and voluntary business for current and prospective clients. This includes, but is not limited to, the review and utilization... Provide specialized study support and assistance to clinical teams in the preparation and development of master and country-level clinical site budget templates utilizing industry benchmarking to ensure fair market value pricing.Perform budget review. We recommend you enter a location since many remote jobs have city, state or country requirements. If you re looking for a fulfilling career, then it s time to join the Crown Heights Center for Nursing and Rehabilitation team as an LPN.
Overseeing the quality of clinical care for network and non-network providers. The average utilization review nurse in Ridgefield Park, NJ earns between $58,000 and $105,000 annually. This compares to the national average utilization review nurse range of $47,000 to $89,000. At DRIFT, we work with healthcare companies across the United States to help recruit for frontline staff positions.
Utilization Review Jobs - Remote Work From Home & Flexible
Draft letters to send to members outlining benefits and other considerations.
Utilize provider billing manuals to obtain billing guidelines and requirements. Special Handling billing included not limited to interim bills, overlap review, redistribution of money... Review electronic medical records of emergency department admissions and screen for medical necessity, using InterQual or MCG criteria. Participate in telephonic discussions with emergency department physicians relative to documentation and admission...
Timely concurrent and retrospective appeals are a priority. Description Absolute Care offers concierge health services using a risk-bearing, PCP-driven care model. We treat the most clinically complex and vulnerable members of the communities we serve, many... Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connec...
Review medical claims data for accuracy and assist with the resolution of any discrepancies. Provide timely medical reviews that meet the brand's stringent quality parameters. Provide clinical determinations based on evidence-based criteria while utilizing clinical acumen. Clearly and accurately document all communication and decision-making... Identifying and implementing evidence-based practice guidelines throughout the provider network.
Advise, assist and educate treating physicians, hospital care managers, senior medical management, administration and all others involved in the delivery of timely, appropriate and cost-effective care. Full-time administrator who possesses the training and education necessary to meet the requirements for quality improvement/utilization review activities required in the Contract. Provide organizational leadership in the operational areas of care management, utilization review, appeals, quality improvement and related policy and practice initiatives in collaboration with the Corporate Medical Director, Utilization Management... Document clearly and concisely, following hospital guidelines, all communications, interactions, interventions and outcomes of medical director work in care management documentation system. Promote hospital adherence to ensure compliance with government and commercial payors policies regarding level of care and medical necessity. Conduct financial and healthcare utilization analysis and reporting to support Medicaid program compliance and evaluation.
We are currently looking for a Licensed Practical Nurse who can complement our current Nursing Staff. If you re looking for a rewarding career in the healthcare industry, look no further than Seagate Nursing and Rehabilitation Center. For those who want to invent the future of health care, here's your opportunity. We're going beyond counseling services and verified referrals to behavioral health programs integrated across the en...
No comments:
Post a Comment