- Novo Nordisk Inc. (Irvine, CA)
- …other field-based employees (eg, DBMs, DCSs, Market Access Team, Diabetes Educators, Medical Liaisons) covering the same geographic areas. The Specialty Field Sales ... and unique insights Leverages superior understanding of complexities within the targeted physician customer base in order to maximize performance Applies high level… more
- Yale New Haven Health (Waterford, CT)
- …This individual will serve as the link between the patient, medical oncology, radiation oncology, and medical infusion. EEO/AA/Disability/Veteran ... health care needs. Evaluates laboratory values correctly and notifies physician of abnormalities; assesses continuance of medication. 2. Provides instruction… more
- Christus Health (Texarkana, 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
- Fresenius Medical Care (Fitchburg, WI)
- …involves staff in problem solving. PHYSICIANS: Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. ... communicated to and implemented by the facility staff. Maintains integrity of medical records and other FMS administrative and operational records. Complies with all… more
- The Laurels of Bedford (Battle Creek, MI)
- …time frames. Assesses resident through physical assessment, interview and chart review . Discusses resident care needs with care givers, including physician ... PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator...At The Laurels, caring is more than providing excellent medical and guest services. It's also being a companion,… more
- Fresenius Medical Care (Greensboro, NC)
- …Manages staff scheduling and payroll. PHYSICIANS: Facilitates the application process for physician privileges and compliance with Fresenius Medical Care ... Medical Staff By-Laws. Responsible for strong physician relationships and ensures regular and effective communication. Participates in Governing Body, an… more
- UTMB Health (Galveston, TX)
- …to budget planning, fiscal and resource planning/administration, human resource utilization , policy administration, and coordination and negotiation of activities ... followed accordingly with regard to faculty appointments, promotions, and tenure review . Identifies and adheres to appropriate internal controls for department and… more
- The Laurels of Fulton (St. Johns, MI)
- …interdisciplinary team Assesses resident through physical assessment, interview and chart review . Discusses resident care needs with care givers, including ... physician , nursing, social services, therapy, dietary, and activity staff....PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator… more
- Carle Health (Urbana, IL)
- … issues in appropriate locations, including but not limited to: case management/ utilization review software and the multidisciplinary plan of care document ... Responsibilities Act as a liaison working with patient/family and physician to determine next level of care Conducts case... to determine next level of care Conducts case review presentations to educate peers on unique or challenging… more
- Carle Health (Champaign, IL)
- …patient care outcomes. The incumbent will have a deep understanding of utilization review and case management principles, case management best practices, ... experience 2+ years Responsibilities Maintain current knowledge of case management and utilization review trends including the entire continuum of care within… more
- Mercy (Lebanon, MO)
- …resolves, and prevents medication-related problems through intervention with the physician . Supervises and directs pharmacy support personnel to ensure the ... with our mission, values, and Mercy Service Standards. Primary Responsibilities: Review patient records to assess appropriateness of medication therapy Evaluate… 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
- Hackensack Meridian Health (Hackensack, NJ)
- **The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... population and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… 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
- Integra Partners (Troy, MI)
- …as operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director(s), ensures consistent application of ... representing Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director's responsibilities include but… 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
- Huron Consulting Group (Chicago, IL)
- …Management is responsible for planning, organizing, developing, and directing implementation of the Utilization Review Plan and the overall operation of the ... + Staff Acquisition and Support: Leads and manages the utilization review staff and function for the...intensity of services, escalating cases as necessary to payers, physician advisors, leadership, or the medical team.… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... concurrent medical record review for medical ...this position is able to cover a multitude of utilization review functions through point of entry,… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case Management -... Medical Necessity and submits case for Secondary Physician review per Tenet policy Ensures timely ... management system Follows the payor dispute processes utilizing secondary medical review , peer to peer and payor...level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as… more
- Sedgwick (Cincinnati, OH)
- …provider's office. + Utilizes evidence-based criteria and jurisdictional guidelines to form utilization review determinations. + Pursues Physician Advisor ... Fortune Best Workplaces in Financial Services & Insurance RN Utilization Review **Join us in a hybrid...+ Identifies treatment plan request(s) and obtains and analyzes medical records that support the request. + Clarifies unclear… more
