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Evangelical announces UR/CDI/denials director

LEWISBURG Karen Schuler, BSN, RN-NI, has been named Director of Utilization Review, Clinical Documentation Integrity, Denials for Revenue Cycle at Evangelical Community Hospital.

Karen schulerUtilization reviewClinical documentation integrity

Heather Hastings of Coloma receives LMC Spirit of Nursing Award

Heather Hastings of Coloma receives LMC Spirit of Nursing Award
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Denise gardnerHeather hastingsLake michigan college spirit of nursing awardCorewell healthUtilization review departmentBenton harbor high schoolLake michigan collegeNursing awardCorewell health southUtilization reviewCardiac progressive careDirector denise gardner

LVN Care Review Clinician, Prior Authorization at Molina Healthcare Inc

For this position we are seeking a LVN PRIOR AUTH NURSE with at least 3 years experience in Outpa.

United statesBehavioral health care review cliniciansMolina healthcare servicesMolina healthcareOutpatient prior authorizationAcute careUtilization reviewUtilization managementHealthcare servicesMedical directorsMolina careRegistered nurseLicensed vocational nurseLicensed practical nurseState registered nursingUtilization management certification

Medicaid pharmacy benefit use in Canada

Medicaid pharmacy benefit use in Canada
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United statesService category standardsAdvisory councilService category cost sharing standardsImplementation of national pharmacareNational pharmacareMedicaid pharmacySharing limitsService categoryAffordable care actCategory cost sharing standardsPrescription drugPrescription drug utilizationUtilization reviewPrescription drug benefitEmployee protection toolkit

After pandemic downturn, worker s comp medical disputes up again in California

Review shows 4.1% increase in first half of 2023, mostly in physical therapy, injections, prosthetics

United statesCalifornia worker compensation instituteIndependent medical reviewUtilization reviewMedical treatment utilization schedulePrescription drug formularyPain managementOpioid guidelinesWorkers x2019 compOrkers comp dispute