Utilization review nurse jobs in Pompano Beach, FL

Knowledge of ABA services and BH utilization review process preferred. Experience working with providers.. Registered Nurse. State Licensure and or Compact State Licensure required Board Certified Behavior..

Overview. Responsible for the receiving and preparation of cases for the utilization review process.. Responsibilities. Essential Functions. Identify and prioritize tasks received from nurse Utilization..

Healthcare provider is currently hiring a permanent Utilization Manager for a full time position.. Ensure state and company compliance program guidelines are always adhered to. Review company policy and..

Retrospective chart review for clinical financial resource utilization. Coordinates with healthcare team.. Associates Licenses & Certifications. MCG Care Guidelines Specialist Registered Nurse Additional..

Shift 1FTE. 1.000000Summary Performs and monitors integrated, concurrent utilization review and case.. Two YearsCredentials Essential. Basic Life Support. Registered Nurse. Bonus Exclusions may apply in..

years of experience as a Registered Nurse. Must possess 1. years of clinical experience in acute or post acute setting. Must have active current and unrestricted RN licensure in state of..

Utilization Management is responsible to collaborate with healthcare providers and members to promote.. Licensed NursePlease be advised that Elevance Health only accepts resumes for compensation from agencies..

Description of BenefitsHumana, Inc. and its affiliated subsidiaries (collectively,. Humana ) offers competitive benefits that support whole person well being. Associate benefits ar..

Job Title Transaction Review Desk Support Corporate Title Assistant Vice President Location Jacksonville, FL Overview The Sanctions & Embargoes program is aimed to ensure that the Bank Group and..

Works with the Utilization Management team primarily responsible for inpatient medical necessity.. Provides daily review and evaluation of members that require hospitalization and or procedures providing..

To supervise the review of payment requests for accuracy and completeness of required submittals.. Supervise the review of payment requests for accuracy and completeness of required submittals..

Description. Loan Review Senior ConsultantCrowe is seeking a Loan Review Senior Consultant to perform.. In this role, you will Provide loan review services and other consulting engagements with clients on..

Position Overview. At Zelis, the Itemized Bill Review Facility Reviewer is responsible for analyzing.. They will work closely with Hospital Bill Review and Concept Development staff to efficiently identify..

JOB SUMMARY The Transfer DRG Revenue Review Specialist performs work to capture lost revenue for.. The company has reviewed this job description to ensure that the essential functions and basic duties..

Medical Review Team POSITION LOCATIONThis position is available to Virginia residents as Richmond or.. What you bringActive Registered Nurse (RN) licensure At least two years experience working in a role..

As a Credit Risk Review Advisor within PNC's Credit Risk Review organization, this position is primarily.. Additional locations may be considered.The primary objective of Credit Risk Review (CRR) is to conduct..

Check you match the skill requirements for this role, as well as associated experience, then apply with your CV below. De Novo, a boutique staffing and recruitment agency, is curre..

DescriptionMedical Director Opportunity. Medicare Risk Adjustment HCC Review. Puerto Rico (Option to be.. Advises manager of possible trends in inappropriate utilization (under and or over), and other quality..