Utilization Management Nurse II - Case Management
criteria sets for admission reviews, continued stay reviews, outlier reviews, and clinical appropriateness recommendations...
criteria sets for admission reviews, continued stay reviews, outlier reviews, and clinical appropriateness recommendations...
expected reimbursement for outlier claims and claims with days denied as not medically necessary. Refers patients for Financial...
management leaders for challenging, high conflict or outlier case circumstances. Collaborates with stakeholders across the care...
executive team, external stakeholders, and public policy experts to enhance Scale AI and Outlier's reputation as a leader...
. Designing and driving experiments, A/B testing, outlier deep dives and form actionable recommendations, then managing the...
and implement discharge plans for patients to meet their needs for post-acute care services, avoid outlier days, reduce the length...
discharge plans for patients to meet their needs for post-acute care services, avoid outlier days, reduce the length of stay...
events, special promotions). Work with the General Manager on developing action plans for outlier performance based on the...
to determine outlier days, approved days, etc., and releases accounts as appropriate. 7. Checks admission and discharge dates. 8...
and progress including admission, continued stay, and discharge criteria. Chairs weekly Interdisciplinary Outlier Committee...