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
...Key Responsibilities: Maintain cleanliness and sanitation standards in the kitchen and dining areas. Operate and maintain dishwashing equipment. Assist with the setup and breakdown of banquet and event spaces. Ensure all kitchen utensils, dishes, and equipment...
...retailers and real estate assets.YOU WILL BE: As a Personal Stylist Assistant, you will assist your stylist with client communication, outfit... ...medical, vision and dental)An amazing employee discountFashion retail experienceWork flexible scheduleSALARY AND OTHER BENEFITS...
...Havasu Regional Medical Center and an established private orthopedic group located in a beautiful lakeside community in Western Arizona... ...is seeking a board-eligible or board-certified orthopedic spine surgeon to join their team. With over 20 years of service to the community...
...Wargamings Center for Player Insights is hiring an experienced UX Researcher to champion player needs and inform product decisions across live-service and in-development titles.You will partner closely with game teams, including UX Design, Game Design, Product Management...
...Type Non-Management Pay Range: $25.50-$25.50 per hour Tip Eligible: Y POSITION SUMMARY Wash, mop, and clean the pool deck. Promote a fun and relaxing atmosphere for guests in all recreational activities and areas by expressing an upbeat and enthusiastic...