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
...mother in law suite. It has a separate bedroom, kitchen, living room, and two bathrooms. We also have two cats that live in the mother... ...If you are interested in this rewarding opportunity, please feel free to message us. We look forward to hearing from you soon!Please...
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...Full Stack EngineerThe AI Platform team at Peloton is looking for a full stack engineer to build an interactive data management web application that allows teams to access, label and QA training data for all our computer vision tasks. In this role you will work closely...
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...Camp Host Wage: $17/hrDepartment: General AdministrationStatus: Part time, Non-ExemptOverview:The Camp Host collaborates with and assists the Registration Manager in championing the overall guest experience as well as the daily operation of the front office and check...