- HireMaster (Maryville, TN)
- …of care and timely implementation of plan of care in accordance with hospital(s) Utilization Review Plan and CMS regulation. Maintains expert level knowledge of ... timely contacts with insurers to provide clinical information to support physician referrals. In collaboration with physicians, leads the multidisciplinary team… more
- Kaiser (Hillsboro, OR)
- Job Summary: Full -time associate as a Behavioral Health Associate (BHA) or Mental Health Associate (MHA). The BHA or MHA provide expert integrated care to pediatric ... with the ability to successfully pivot from a patient facing to a physician facing role throughout the day. Associates must thrive on being adaptable, flexible,… more
- Christus Health (Tyler, TX)
- …therapy department.Participates in medical chart peer review , case record review and utilization review as deemed necessary.Assumes responsibility ... sets goals, plans programs and treats patients according to the physician 's orders; maintains required records and notes; assists with directing technicians… more
- Health eCareers (Columbia, SC)
- …of care and timely implementation of plan of care in accordance with hospital(s) Utilization Review Plan. – 10%Promotes effective and efficient utilization ... management service for hospital patients, including, but not limited to, utilization management to ensure efficient, cost–effective patient progression through the… more
- Kaiser (Hillsboro, OR)
- …necessity for durable medical equipment, and out-patient education in effective utilization of prescribed respiratory medical interventions. Meets ATS standards 90% ... pulmonary function testing equipment.Measured by quality control monitoring, pulmonary physician interpretation of test results.Durable Medical Equipment Evaluations:Perform respiratory… 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 ... accuracy and completeness of clinical information used for measuring and reporting physician and medical center outcomes with continuing education to all members of… more
- Sutter Health (Sacramento, CA)
- …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Some awareness ... services. The PA will develop expertise on matters regarding physician practice patterns, over- and under- utilization of...excellence in the patient experience. **Job Shift:** Days **Schedule:** Full Time **Days of the Week:** Monday - Friday… 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 ... Medical Center. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case...Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. The… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE ... see comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're… 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 ... **Job Type:** Regular **Time Type:** Full time **Work Shift:** Day (United States of...billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review … more
- The County of Los Angeles (Los Angeles, CA)
- …Organization guidelines and the Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...$177,314.88 Annually Location Los Angeles County, CA Job Type Full time Job Number Y5126D Department HEALTH SERVICES Opening… more
- Commonwealth Care Alliance (Boston, MA)
- …Group **Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director ... our rapidly growing membership. The incumbent will have significant experience with utilization review , ideally experience with public programming, and excellent… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- …- is accepting applications for a full -time Utilization Review ... Utilization Review Nurse Coordinator Office/On-site Recruitment...review of cases and case referral to a physician consultant for final disposition; + Performs related duties… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.Thisis a full -time role. *Purpose of this position: ... *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which...actions to UR Committees, as appropriate * Partners with Physician Advisor to engage in second level review… more
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr CMC- Clear Lake Center **Webster, Texas, United States** **New** Nursing & Care Management UTMB Health Requisition # 2505026 The ... or observation in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and retrospectively… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
- Dayton Children's Hospital (Dayton, OH)
- …concurrent and retrospective denials. The Physician Advisor role will support the Utilization Review RN for second level clinical reviews for cases that do ... Facility:Dayton Children's - Main CampusDepartment: Utilization Review TeamSchedule:Part timeHours:8Job Details:Under the supervision of the Manager of … more
- Beth Israel Lahey Health (Plymouth, MA)
- …you're not just taking a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management ... **Job Type:** Regular **Time Type:** Full time **Work Shift:** Day (United States of...causes of denials for discussion with the internal team, physician advisor and the Utilization Review… more
- HonorHealth (AZ)
- …communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... want to make an impact. HonorHealth offers a diverse benefits portfolio for our full -time and part-time team members designed to help you and your family live your… more
- HonorHealth (AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of ... want to make an impact. HonorHealth offers a diverse benefits portfolio for our full -time and part-time team members designed to help you and your family live your… more
