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
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...players who will help us to provide excellent delivery and pick-up service to our customers.... ... ensure you give and take the correct parts and quantities at the correct customer sites... ...techniques, What Youll Need Driver's license have a valid license with a clean...
...trust. We're investing heavily in data and AI to sharpen how we... ...Startup Employers, a Great Place to Work, an Inc. Best Workplace, and... ...looking for a mid-level Data Analyst who is far more than a report... ...position Monthly work-from-home stipend Generous paid time...
...is seeking an Associate Territory Representative to launch a medical device sales career in Columbus, OH. You will hunt for new business in... ...coaching and a clear path to Territory Manager roles. This entry point role emphasizes disciplined prospecting, high call volume...