The Registered Nurse (RN) - Utilization Review monitors patient charts and records to evaluate care concurrent with the patients treatment. Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Being a Registered Nurse (RN) - Utilization Review collects and complies data as required and according to applicable policies and regulations. Reviews treatment plans and status of approvals from insurers. In addition, Registered Nurse (RN) - Utilization Review consults with physicians as needed. May require a bachelor's degree. Typically reports ... view job details

Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Consults with physicians as needed. May require a bachelor's degree. Typically reports to a supervisor. Typically requires Registered Nurse(RN). Contributes to moderately complex aspects of a project. Work is generally independent and collab... view job details

Performs each review process following the appropriate policy & procedure and within standard time frames. Maintains reports relating to the implementation, coordination, and follow-up of medical management review processes and special projects. Interacts with Data Management and appropriate Supervisor to provide system maintenance to the Referral and Case Management applications. view job details

Conduct remote utilization reviews of medical records to determine the appropriateness and necessity of healthcare services. Provide education and support to healthcare providers and staff regarding utilization review processes and requirements. Communicate with healthcare providers to gather additional information and clarify documentation related to patient care. view job details

The Care and Utilization Review Nurse Manager oversees staff that process referrals, authorizations, billing, utilization review, and capitation for hospital services. Supervises and coordinates activities of personnel in the managed care operations department of a healthcare facility. Being a Care and Utilization Review Nurse Manager requires a bachelor's degree. Experienced in utilization review techniques and protocols. In addition, Care and Utilization Review Nurse Manager typically reports to a manager or head of a unit/department. May require Registered Nurse (RN). Makes day-to-day decis... view job details

The rules of performance reviews are changing. Not too long ago, management guru Peter Block said, 'The performance review is the company's opportunity to prove to you, once again, that they own you.' But as employees gain better access to information and assume more responsibility for managing their careers, the performance review is becoming another opportunity for you to demonstrate value to your company.The Purpose of a Performance ReviewPerformance reviews give employees and employers a chance to evaluate regularly whether they are happy with each other. The review is a meeting between yo... view article details

Typically, employees have performance reviews once or possibly twice a year. You might have a performance review after your first three months in a new job, to make sure it's a good fit. If it has been more than two years since your last performance review and your last raise, you are probably overdue.Some companies schedule everyone's performance review at the same time, for example the end of the calendar year. Others conduct performance reviews at employees' anniversary dates. In either case, make sure your review happens. If your company seems to be dragging its feet, take the initiative t... view article details

Most employers conduct salary reviews as part of the performance review cycle. This is one of the best opportunities to negotiate for more pay. Startup companies and other employers may offer a salary review after the first three to six months on the job.Many companies believe in separating the performance review from the salary review, because one is an evaluation and the other is a negotiation. But the business world moves so fast that that the two discussions are often combined.Companies set budgets for pay increases. Usually the budget calls for the average employee to receive a 4 percent ... view article details

Educate Employees as to How Performance Reviews Affect Their Pay It's Performance Review Season. Is Your Process Working? Insight from Employees on Performance Reviews and Seven Tips for Everyone to Get More from the Process EMPLOYER MYTH #1:  Your employees "Get It." FACT:  Many employees don't understand how the performance review impacts their compensation. Generally speaking, the majority of employees don't have a clear understanding of how their employer links pay to performance. For managers who have been trained in the organization's performance management program and merit budg... view article details

Exceeding your annual performance expectations may seem impossible. But, according to Nick Camelio, Vice President of Human Resources at Salary.com? that doesn’t have to be the case. The key to exceeding your performance expectations is to be an active participant in establishing your goals from the start. By focusing on key objectives and defining a plan that makes sense for you and your employer, you are on your way to meeting and exceeding your performance goals. To help get you started, Camelio offers the following 6 tips:1. Understand your Role The first step ... view article details

Conducting a successful compensation review. Step 1. State your goals and philosophy. Step 2. Gather data. Step 3. Analyze the data. Step 4. Develop your compensation strategy. Step 5. Implement and monitor the strategy. Employers are having a hard time keeping workers, especially with the current competitive job market. In 2022, over 50 million Americans took part in “the Great Resignation,” a trend where many quit their jobs on their own. A survey found that this happened because workers felt disrespected, lacked opportunities for advancement, and were paid too little. To prevent this proble... view blog & white papers details

So, another year has flown by. As you look back over the last 12 months, what stands out? What were your biggest wins and key highlights? What obstacles did you overcome? It is important to take the time to reflect on your journey and growth throughout the year. Doing an annual year-end review is one of the best ways to gain valuable insights into what is working, determine where you can improve, and set new goals to crush next year. When you make it a habit to pause, evaluate your progress, and plan, you put yourself in the driver's seat of your own success and development. Use your year-end ... view blog & white papers details

To attract and retain the best employees, your organization must offer a competitive compensation and benefits package. You can't just leave these packages alone and expect results, however. Instead, you need to regularly review and update your compensation and benefits packages to keep them up-to-date and attractive to job seekers and employees. If you're unsure where to begin, don't worry as we have you covered! In this article, we will provide 10 steps that will help you review and update compensation and benefits packages. Without further ado, let's dive into the first step. Determine Wha... view blog & white papers details

Faye Ashley seemed destined for a career as a dental assistant. Her mother was a nurse, her sister, a nurse practitioner. She took yearlong dentistry courses at a Pennsylvania community college before landing a $10.50-an-hour job at a small practice in Greensburg, Pennsylvania. view blog & white papers details

Faye Ashley seemed destined for a career as a dental assistant. Her mother was a nurse, her sister, a nurse practitioner. She took yearlong dentistry courses at a Pennsylvania community college before landing a $10.50-an-hour job at a small practice in Greensburg, Pennsylvania. view blog & white papers details