- 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
- 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
- Monster (Mclean, VA)
- …and Development, Physician Review Panels, Quality of Care Review , Outcome Measurement Programs, HIPAA Privacy Expertise, Utilization Review , ... employed physician reviewers, part time and contract physician reviewers, and assistant Medical Directors. Provides...A minimum of five (5) years of experience in utilization review . Must hold an active license… 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
- 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
- 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
- jobvibe (Conway, NH)
- …of interventions to achieve patient goals and minimize re- hospitalizations; Participates in review and revision of plan of care; Provision of Direct Patient Care: ... Administers medications and performs treatments per physician orders; Communicates pertinent data to RN and/or physician ; Documents accurately and thoroughly;… 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
- 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
- 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
- Emory Healthcare/Emory University (Atlanta, GA)
- …attending physician and/or physician advisor. This individual will: + Perform utilization review by completing a timely and comprehensive review of ... and leadership programs + And more **Description** We're seeking an **Inpatient Registry Utilization Review Nurse (PRN)** who is responsible for conducting … more
- Houston Methodist (Nassau Bay, TX)
- FT position for experienced UR/CM nurse. At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who ... comprehensively conducts point of entry and concurrent medical record review for medical ...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …mentorship, _development,_ and leadership programs + And more **Description** The ** Utilization Review (UR) Specialist** is a Registered Nurse responsible ... for conducting thorough medical necessity reviews to assist with determining appropriate patient...experience or a minimum of two years of previous utilization review experience. + Must have a… more
