To ensure appropriate resource utilization and minimize payment denials, the full-time remote Maryland Licensed Utilization Review Nurse will conduct initial, concurrent, and retrospective chart reviews while coordinating with healthcare teams and third-party payers. Key responsibilities: Review medical records using utilization review criteria to assess clinical and financial resource consumption Maintain communication with external reviewers and perform certification activities as required by payors Document actions taken to coordinate care, avoid denials, and assist in communicating with patients regarding discharge plans Required qualifications: ADN required; BSN preferred 3-5 years of Utilization Review experience, preferably in an acute hospital setting Current Maryland Registered Nurse License or eligibility to obtain
...Research Associate 1 The University of Miami's College of Arts and Sciences has an exciting opportunity for a full-time Research Associate 1 to work in Coral Gables, FL. The Department of Psychology, in the College of Arts & Sciences, is seeking a full-time Research...
...Job Title : Sanitation Worker FLSA Status: Non-Exempt Reports to :DepartmentManager or Lead Supervises : N/A Travel: As needed according totheessential functions of position Department: Sanitation JOB PURPOSE: The primary...
...BioLife Plasma Screener This position requires open availability, including weekdays, evenings, and weekends. Applicants must be able... ...comprehensive benefits program to include retirement benefits, medical/dental, family leave, disability insurance and more, all in a...
...Frito Lay is hiring for various positions including production workers, delivery drivers, and sales representatives. Competitive wages with comprehensive benefits package. Join a leading snack food company with diverse brands and products. Opportunities for career growth...
...spaces such as decks, porches, sunrooms, hardscape patios, and shade structures.We seek construction professionals with established carpentry expertise to work on our residential building & remodeling projects. You will primarily be responsible for delivering the finished...