To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care determinations. Key responsibilities Conduct medical-necessity reviews to evaluate services against benefit language and medical policy Escalate non-certifications to the Medical Director, ensuring timely and defensible adverse determinations Analyze clinical documentation for completeness and manage a caseload based on urgency and member impact Required qualifications Current, unrestricted RN license in the United States or a U.S. territory Graduate of an accredited nursing program (ADN or diploma required; BSN preferred) 1-2+ years of recent clinical experience in acute care, med-surg, ICU/ED, or similar settings Utilization review or utilization management experience preferred Proficiency with Microsoft Word, Excel, and Outlook, along with knowledge of ICD-10, CPT, and HCPCS coding
Animal Care Hospital, a full-service small animal clinic in Cedar Rapids, IA, seeks an Associate Veterinarian to provide high-quality medical, surgical, dental, and preventive care for dogs and cats. Youll perform exams, diagnose and treat illnesses, manage anesthesia...
...Job Description Job Description Apply Today, Work Today Weekly Pay Job Description: We are Hiring Immediately for a Picker & Packer position! Find and collect merchandise in a warehouse and prepare the items for shipment to customers. May use a computer or...
...knowledge of sound editing (noise reduction, leveling, file formatting).Access to a high-... ...stylesBackground in acting or performing artsFamiliarity with audio editing toolsPerks... ...complete your profile.Seniority levelEntry levelEmployment typeContractJob function...
...looking for organized, proactive individuals to join our remote travel team and keep things running smoothly behind the scenes.... ...confirming travel schedules, bookings, and itinerary details Coordinating with clients to align travel plans with their needs and preferences...
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