- WORKCARE INC (Albany, OR)
- …company policies/procedures. Coordinates care with other WorkCare programs, using physician escalation services, as needed. Provides evidence-based practices and ... practice and as supported by the CMD or Medical Review Officer (MRO). Assists the CMD with health care...to incident reports and tracking of injury and clinic utilization data. Actively participates in emergency response team activities,… more
- US Fish and Wildlife Service (Titusville, FL)
- …and instruct lower graded employees on crewmember duties; 2) plan action and direct utilization of fireline resources on less complex fires; and 3) for more complex ... cleanliness for engine resupply. Performs specialized duties such as water handling specialist or maintenance of specialized equipment used to respond to wildland… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Utilization Review Specialist (RN) Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 Hours ... (Full-Time) Schedule: Monday - Friday, Days SUMMARY:The Utilization Review Specialist actively participates in the utilization management of patients and… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) responsible for promoting the ... the Utilization Review Nurse and Utilization Review Specialist Nurse job...and data in a comprehensive manner. + Works with physician leadership and the interprofessional health care team for… more
- Trinity Health (Maywood, IL)
- …is Loyola campus. Position is hybrid, must reside in Illinois. The **Regional Utilization Review Documentation Specialist ** nurse works with the ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Utilization Review - RN Reviewer- Regional Coverage for Loyola, Gottlieb and MacNeal… more
- HonorHealth (AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors utilization ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.This is a full-time role and will be required to work ... this position: *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include… more
- HonorHealth (AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Health Advocates Network (Harrisburg, PA)
- Physician Specialist -NDC- Advanced **Pay Rate: ** $160 / hour *1099 Minimum Qualifications Be board certified in the requested specialty. Possess an active ... twenty (20) hours per month. Demonstrate an understanding of utilization review processes. Basic computer skills to...Description: Resource in this position will serve as a physician reviewer for the Department of Public Welfare. Resource… more
- Mohawk Valley Health System (Utica, NY)
- … regarding correct level of care and reimbursement. Apply knowledge of utilization review , discharge planning, patient status changes, length of stay, ... billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of...and quality patient care while ensuring effective and efficient utilization of resources. The Physician Advisor guides… more
- HCA Healthcare (Lake City, FL)
- …and personal growth, we encourage you to apply for our Provider Solutions Specialist opening. We promptly review all applications. Highly qualified candidates ... **Introduction** Do you have the career opportunities as a(an) Provider Solutions Specialist you want with your current employer? We have an exciting opportunity… more
- HCA Healthcare (Dallas, TX)
- …staff performance evaluations. + Acts as manager in charge as assigned. + Provides review and guidance on physician order sets and other evidenced based ... in daily multidisciplinary and bedside rounds + Completes drug utilization reviews to promote rational drug therapy and implement...we encourage you to apply for our Clinical Pharmacist Specialist BMT opening. We promptly review all… more
- LA Care Health Plan (Los Angeles, CA)
- …and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Enhanced Care Management Clinical Specialist II Job Category: Clinical Department: Care Management...Light Additional Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM),… more
- HCA Healthcare (Portsmouth, NH)
- …of case review , data abstraction, management and reporting. The Sr. Specialist will actively provide support and carry out assigned functions within the Patient ... in support of improvement initiatives * Contributes to the physician performance improvement program including Peer Review ...encourage you to apply for our Sr Clinical Quality Specialist opening. Our team will promptly review … more
- HCA Healthcare (Dallas, TX)
- …acute inpatient rehabilitation services prior to returning home. The Clinical Rehabilitation Specialist will review these patients daily until they have strong ... clinical evidence to request a physician order for a formal pre-admission assessment for acute...we encourage you to apply for our Clinical Rehab Specialist opening. We promptly review all applications.… more
- HCA Healthcare (Richmond, VA)
- …acute inpatient rehabilitation services prior to returning home. The Clinical Rehabilitation Specialist will review these patients daily until they have strong ... clinical evidence to request a physician order for a formal pre-admission assessment for acute...we encourage you to apply for our Clinical Rehab Specialist PRN opening. We review all applications.… more
- UPMC (Pittsburgh, PA)
- …daylight hours. The position will be fully remote! In this role, the DRG Specialist II will review clinical documentation within the medical record to ensure ... UPMC Corporate Revenue Cycle is hiring a DRG Specialist II to join our coding team! This...that all patient resource utilization , diagnostic complications and co-morbidities have been coded in… more
- HCA Healthcare (Overland Park, KS)
- …and personal growth, we encourage you to apply for our Clinical Pharmacist Specialist AMP Quality opening. We promptly review all applications. Highly qualified ... We care like family! Jump-start your career as a(an) Clinical Pharmacist Specialist AMP Quality today with Overland Park Regional Medical Center. **Benefits**… more
- HCA Healthcare (Nashville, TN)
- …treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile ... on face to face or telemedicine assessment completed and physician consult. + Provides a thorough clinical review...patients in regard to managed care organizations + Conducts utilization review for managed care cases in… more
- HCA Healthcare (Campbell, CA)
- …find this opportunity compelling, we encourage you to apply for our Contract Specialist opening. We promptly review all applications. Highly qualified candidates ... worth of each individual is recognized. Submit your application for our Contract Specialist opening with HCA Healthcare today and find out what it truly means… more
