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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...recognize their merit. Job Function: Customer Management Job Sub Function: Technical Field Service Job Category: Business Enablement/Support... ...to facilitate all aspects of technical / engineering work required to support all products supported and...
...Federally Qualified Health Center (FQHC), is the largest community health center system in Northwest Ohio with partnerships that include ProMedica, Mercy Health, and University of Toledo Medical Center. NHA has grown from a single location in 1969 to 12 medical and dental...
...Industrial Abrasive Blaster Job Description The Industrial Abrasive Blaster prepares steel tanks and other steel structures for coating... ...abrasive blasting using media such as steel grit, Black Beauty, or Starblast. This role involves setting up and operating dry-...