Utilization Management Nurse II - Case Management
for admission reviews, continued stay reviews, outlier reviews, and clinical appropriateness recommendations. Coordinate...
for admission reviews, continued stay reviews, outlier reviews, and clinical appropriateness recommendations. Coordinate...
and implement discharge plans for patients to meet their needs for post-acute care services, avoid outlier days, reduce the length...
and other significant clinical changes Actively participates in CLT meetings with COD and CTD to improve quality, patient safety, outlier...
to improve quality, patient safety, outlier management, and ensures the ongoing development and growth of the center’s business...
and implement discharge plans for patients to meet their needs for post-acute care services, avoid outlier days, reduce the length...
, or related field Familiarity with predictive analytic models like time-series, outlier, and forecast models Knowledge of Public...
criteria sets for admission reviews, continued stay reviews, outlier reviews, and clinical appropriateness recommendations...
full investigations, including but not limited to witness interviews, background checks, data analytics to identify outlier...
. As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier, and Readmission reviews...
learning experience with various regression, classification, and outlier detection models using structured and unstructured...