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
Responsibilities: - Create an English learning environment through work cycle and some ESL classes - Cooperate with lead teacher(Chinese, but English speaking) to make sure the safety, educate of children Education Requirements: - BA degree with at least 2+ years...
...standards of professionalism and hospitality. Qualifications: Minimum 23 years of server experience in a fine dining, private club, or upscale hospitality environment. Previous leadership or trainer experience strongly preferred. Excellent communication and...
...IMMEDIATE OPENINGS! Come for a job and stay for a career! Federal Express Corporation (FEC) is part of the rapidly growing warehouse and transportation sector that helps keep America, and our economy, moving. Be part of a winning team and workplace community that cares...
...Job Description Job Description Part time High School History Instructor for 9th thru 12th grade . Schedule includes four 40 minute periods of instruction between 3:00 and 6:30 PM with some flexibility. Strong content knowledge and experience with Regents aligned curriculum...
...professionals are essential to fulfilling this promise. PanCare of Florida is seeking a skilled and compassionate Pediatric Nurse Practitioner (PNP) or Advanced Practice Registered Nurse (APRN) to join our Pediatrics team in Panama City. In this role, you will provide...