Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews provider requests for inpatient and outpatient services, working closely with members and providers to collect all information necessary to perform a thorough medical necessity review. It is within the nurse's discretion to send requests for additional information and/or request clarification. The nurse will use his/her professional judgment to evaluate the request to ensure that appropriate services are approved and recognize care coordination opportunities and refer those cases as needed. The nurse will apply medical health benefit policy and medical management guidelines to authorize services and appropriately identify and refer requests to the Medical Director when guidelines are not met. The nurse will maintain current knowledge and understanding of the laws, regulations, and policies that pertain to the organizational unit's business and uses clinical judgment in their application.
• Three to five years - 3 or more years' experience in a related clinical setting.
• Registered Nurse
• Registered Nurse graduated from an accredited program.
• Current unrestricted IA Registered Nurse license.
• Valid Driver's License and reliable automobile transportation for on-site assignments and off-site work related activities.
...technology adoption, and optimize critical processes. We are seeking a highly experienced Senior Engineer with 7-15 years of progressive experience to join our aerospace team at the Chatsworth facility. This senior role combines advanced technical expertise in design,...
Gordon Food Service is looking for an Outside Food Sales Representative based in Mentor, Ohio. The ideal candidate will manage sales and develop customer relations, pursuing new clients while enhancing existing relationships.A High School Diploma is required, and candidates...
...Morrison Living is hiring immediately for part time WAITER/WAITRESS positions. Location : Towne House - 2209 Saint Joe Center Road, Fort Wayne, IN 46825. Note: online applications accepted only. Schedule : Part time schedule. Hours and days may vary, including...
...along with and like fast paced, busy workplaces. We often have lines out the door, so we need stable, fun and friendly people to join us. We promote from within, so management is very possible in the future of the right applicant. Full time weekdays and some weekends....
..., service and stewardship to create an environment where associates want to work and help communities thrive. Chaplain I - Rappahannock General Hospital - PRN Job Summary Under the direction of the Director of Mission or Director of Spiritual Care, the Chaplain...