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
...Fifth Grade Self-Contained Elementary Classroom Teacher Guardian Angels Central Catholic School is seeking qualified applicants for a 5th Grade self-contained elementary classroom teacher for the 20262027 school year. The successful candidate will foster student growth...
...driver license Observe and comply with all safety and project rules, perform other duties as required Ability to pass pre-access drug and alcohol testing Equal Opportunity Employer, including disability and protected veteran status. Company: Kiewit_Craft...
Job OverviewWe are seeking a creative and detail-oriented Front-End Developer / Web Developer to join our team. In this role, you will design, build, and optimize responsive, user-friendly web applications and websites. You will collaborate closely with UI/UX designers...
...all platforms.Coach, mentor, and develop newsroom leaders, producers, anchors, reporters, MMJs, and other content, marketing, and production team members.Set clear editorial priorities and ensure our newscasts and digital products consistently deliver meaningful,...
...career with us or just earning some extra cash.Looking to make some extra cash in your spare time or deliver full time? Tried the food delivery or rideshare gigs but tired of them taking most of your money? Come work for Domino's! We pioneered food delivery & in the past...