- CoxHealth (Springfield, MO)
- …for facilitating timely and accurate physician documentation in the medical record through concurrent chart review . Interdisciplinary communication and ... Healthcare Innovation's Top Companies to Work for in Healthcare in 2025. Benefits Medical , Vision, Dental, Retirement Plan with employer match, and many more! For a… more
- Christus Health (Irving, TX)
- …success in CHRISTUS RN Care Manager I position.Case management and Utilization Review experience preferred. Licenses, Registrations, or Certifications RN ... effectively to meet patient need, manage length of stay and promote efficient utilization of resources to include the facilitation of patient care across the… more
- Monster (Salt Lake City, UT)
- Physician , Family Medicine Job Summary As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through ... of Utah Health is seeking a mission-driven primary care physician (MD or DO) to be an integral part...be an integral part of an interdisciplinary team of medical and behavioral health professionals delivering exceptional patient-centered care… more
- Christus Health (Houston, TX)
- …have both verbal and written Communication skills.Must have the ability to understand medical records, physician orders and nursing care plans.Must have the ... unable to do so. Assists DON in the proper utilization of personnel assigned to the care of retired...care of women religious and nursing management through literature review and attendance at seminars/workshops.Utilizes good stewardship in the… more
- Kaiser (Hillsboro, OR)
- … illnesses), stress-related physical symptoms, ineffective patterns of health care utilization , and adjustment to new and chronic medical conditions.Effectively ... to successfully pivot from a patient facing to a physician facing role throughout the day. Associates must thrive...ability to present a case appropriately and professionally for review by the medical home/specialty treatment team,… more
- Tenethealth (Talladega, AL)
- …for reviewing medical records to facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate ... DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Record Review : Completes initial medical records reviews of patient records within… more
- Tenethealth (Bryan, TX)
- …physicians, nursing, and other interdisciplinary team members. Responsible for reviewing medical records to facilitate and obtain appropriate physician ... Analysis and interpretation of regional and facility-specific data and CDI audits Record Review : As needed, completes initial medical records reviews of patient… more
- Tenethealth (Frisco, TX)
- …and plans ensuring alignment with national goals and yearly evaluations Improve Medical CMI throughout Conifer. Responsible for the supervision and coordination of ... and Individual facility leaders including Presidents, CMO, CFO, Facility Physician Service Line Heads, Physicians and other leaders. Communicates/Completes Clinical… more
- Tenethealth (Frisco, TX)
- …coding. Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses ... and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and… more
- Kaiser (Hillsboro, OR)
- …of Pulmonary Function, assessment of medical necessity for durable medical equipment, and out-patient education in effective utilization of prescribed ... pulmonary function testing equipment.Measured by quality control monitoring, pulmonary physician interpretation of test results.Durable Medical Equipment… more
- Christus Health (Tyler, TX)
- …department.Participates in medical chart peer review , case record review and utilization review as deemed necessary.Assumes responsibility for ... sets goals, plans programs and treats patients according to the physician 's orders; maintains required records and notes; assists with directing technicians… more
- Monster (Allentown, PA)
- …Utilizes provider documentation and queries, coding software tools and Insurance carrier medical and reimbursement policies during the claim review process.JOB ... review of supporting documentation, CCI/LCD, carrier policy and utilization of coding software applications.The appeals process may include collaboration with… more
- Health eCareers (Memphis, TN)
- …physicians, other patient caregivers and Facility HIMS coding staff and Revenue Utilization Review Team to ensure clinical documentation and services rendered ... and completeness of clinical information used for measuring and reporting physician and medical center outcomes with continuing education to all members of the… more
- Sutter Health (Sacramento, CA)
- …expertise on matters regarding physician practice patterns, over- and under- utilization of resources, medical necessity, documentation best practices, level ... physician Advisor will work closely with the medical staff, including house staff, and all utilization...within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation… more
- Hackensack Meridian Health (Hackensack, NJ)
- The Utilization Review Physician collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical ... records for the patient population and Hackensack University Medical Center. These include but are not limited to... Center. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case… more
- The County of Los Angeles (Los Angeles, CA)
- …recommendations on potential areas for medical care evaluation studies. + Attends Utilization Review Committee meetings to inform the committee of new or ... Medi-Cal reimbursement. + Analyzes cases for referral to the physician advisor to ensure that the admission or continued...I:One year of experience performing the duties of a Utilization Review Nurse* or Medical … more
- The County of Los Angeles (Los Angeles, CA)
- …administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the ... Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician...for and the effective conduct of the system to review patients' medical charts to ascertain the… more
- Beth Israel Lahey Health (Boston, MA)
- …a difference in people's lives.** Position Summary: In conjunction with the admitting/attending physician , the Utilization Review RN assists in determining ... reviews as directed in the hospital's Utilization Review Plan and review of medical...necessity. 3. Actively seeks additional clinical documentation from the physician to optimize hospital reimbursement when appropriate. 4. Works… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator Office/On-site Recruitment # 250910-5613FP-001 Location East Hartford, CT Date Opened 9/15/2025 12:00:00 AM Salary $86,261 - ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …professional development specialist to develop standard work and expectations for the utilization review process, including timely medical necessity ... actions to UR Committees, as appropriate * Partners with Physician Advisor to engage in second level review...with payers, as appropriate * May participate in the Utilization Review Committee to present medical… more
