- Conduct admission and concurrent reviews for assigned program patients; obtain admission information and insurance verification / benefits information from the Admissions Department.
- Reviews charts and conducts pre-certification reviews with third party payors as required within specified time limits.
- Communicates results of reviews to physicians and treatment team members.
- Serves as liaison to on-site external reviews.
- Maintains relevant reports and data for UR Department.
- Completes all paperwork related to pre-certification and concurrent reviews according to UR policies.
- Daily communication with physicians, treatment team and Business Office regarding certification and denials.
- Coordinate and participate in the treatment planning process.
- Monitor documentation, discharge planning process providing feedback on documentation processes.
- Conducts ongoing reviews of clinical charts.
- Facilitates Peer Review as outlined in Utilization Management Plan.
Administrative policies and procedures and a high level of confidentiality.
Director-Utilization Management
Facilitates Peer Review as outlined in Utilization Management Plan. ...
Registered Nurse, Procedure Nurse, On-Call, Glenlake Medical Office
Licensed registered nurse who has completed training in the care of Specialty Procedure patients (ie General Surgery, Ophthalmology, Orthopedics, Vascular, GYN and Gastroenterology). Registered Professional Nurse License (Georgia) required at hire. Collaborates with practitioners, nurses, patients a...
Travel Nurse - Registered Nurse - TELE - Telemetry - $1458.25 / Week
Atlas MedStaff is seeking an experienced Telemetry Registered Nurse for an exciting Travel Nursing job in Atlanta, GA. Both of those recognitions are fueled by real reviews by real travel nurses and allied healthcare professionals that work with our team. If you don’t have this kind of relationship ...
Travel/Contract - RN-Registered Nurse First Assist (RNFA) - $2936 per week
Genie Healthcare is Looking for a RN to work in Registered Nurse First Assist (RNFA) for a 13-WEEKS travel assignment located in Lawrenceville, GA, for the Shift(07:00:00 to 17:00:00) and 40 hours per week. ...
Travel Nurse - Registered Nurse - TELE - Telemetry - $1542 / Week
Fusion Medical Staffing is seeking an experienced Telemetry Registered Nurse for an exciting Travel Nursing job in Atlanta, GA. Telemetry Registered Nurse travel assignment. Client in Atlanta, GA is looking for a Telemetry Registered Nurse to help them out for 13 weeks. One to three years experience...
Travel Nurse - Registered Nurse - Oncology - $1793.75 / Week
Host Healthcare is seeking an experienced Oncology Registered Nurse for an exciting Travel Nursing job in Atlanta, GA. As a nurse, allied, or therapy professional, you will be matched to one of our responsive recruiters who will have your back throughout your journey. ...
Clinical Review/Utilization Nurse (RN) -PRN
Gathers and reviews relevant medical information and documents utilization review process outcome based on system accepted utilization criteria on the accepted current review forms and in computer systems. Initiates and facilitates physician communications relative to utilization review process when...
Registered Nurse-RN-Medical Surgical Unit-Nights
It is expected that all RN Clinical Nurses are licensed, knowledgeable and uphold the practice of nursing as outlined by the Georgia Professional Nurse Practice Act and implements the Scope of Practice and Code of Ethics Standards put forth by the American Nurses Association. Facility: Cobb Hospital...
Executive Director
The Executive Director reports directly to the Director of Operations and /or COO. Executive Director to join their team!. The Executive Director is responsible for hands on operations execution at the community level. The Executive Director responsibilities include the profit and loss, financial pe...
Assistant Director of Nursing (Assistant Wellness Director) - (LPN)
Responsibilities include assisting in: analysis and evaluation of nursing and related services rendered to ensure quality of resident care; oversight of resident healthcare service’s needs, including the overall medication delivery system and the coordination of in-service training for the Wellness ...