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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We are looking for a motivated attorney with at least one year of transactional experience to join a boutique commercial law firm in Scottsdale... ...to build a practice focused on commercial real estate and contract matters while working closely with experienced legal...
...Job Description Job Description On Call Boiler Operator Location: Dayton, NJ Pay Rate:$35 - $38per hour DOE We currently have an outstanding career opportunity with a global leader in the Fragrance and Flavors Industry. This role is an excellent opportunity...