- Christus Health (Texarkana, 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
- Fresenius Medical Care (Fitchburg, WI)
- …staff in problem solving. PHYSICIANS: Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. Responsible for ... strong Director and physician relationships and facilitating staff relationships with physicians. Ensures...manuals. Accountable for completion of the Annual Standing Order Review and ICD coding. Checks correspondence whether electronic, paper… more
- Mercy (Lebanon, MO)
- …resolves, and prevents medication-related problems through intervention with the physician . Supervises and directs pharmacy support personnel to ensure the ... Position Details: Job Description Clinical Pharmacist - Mercy Springfield - Full -time We're hiring for Clinical Pharmacist - Mercy Springfield Job Summary:… 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
- 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 ... Hackensack UMC. 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
- 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
- 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 ... this position is able to cover a multitude of utilization review functions through point of entry,...process improvements). **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates with the physician and all members of the interprofessional health care… more
- Emory Healthcare/Emory University (Decatur, GA)
- …_,_ and leadership programs + And more **Description** We're seeking a **Clinical Utilization Review Nurse Preceptor (Registered Nurse / RN)** . This individual ... will be responsible for training, mentoring, and coaching for the Utilization Review Department and must be an expert in the utilization review functions… more
- Integra Partners (Troy, MI)
- …operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director(s), ensures consistent application of criteria, ... Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director's responsibilities include but are not… 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...6% you save. + 4 weeks PTO your first full year. **NEXT STEPS** If your application is selected… more
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr - CMC - Clear Lake Center **Webster, Texas, United States** Nursing & Care Management UTMB Health Requisition # 2506588 The mission ... 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
- Providence (Mission Hills, CA)
- **Description** **RN Utilization Review - Remote. This position will work full - time in a 8-hr Day shift.** Provide prospective, retrospective, and ... concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by… more
- Providence (Olympia, WA)
- **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management ... Or Associate's Degree in Nursing + 3 years of Utilization Review , Care Management, Quality Management, and/or...in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska,… more
- UNC Health Care (Kinston, NC)
- …support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying established ... levels of an audit appeal. Works collaboratively with the Physician Advisors and subject matter experts for all audit...experience as a Registered Nurse required. + 2 years utilization review , care management, or compliance experience… more
- Sutter Health (Berkeley, CA)
- …to justify acute hospital admission, need for continued stay, and proper utilization of physician , nursing, and ancillary services. Responsible for concurrent ... with hospital administration, medical staff, patient registration and representatives of review organizations and others to ensure effective utilization of… more
- UNC Health Care (Morrisville, NC)
- …People** - Operational oversight of centralized and site-specific UM teams, including utilization review nurses and support staff. Cultivate and empower ... Guide physician engagement initiatives by developing training programs for physician advisors and advocating for evidence-based resource utilization 3.… more
- Alameda Health System (Oakland, CA)
- …each individual in the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. + ... + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day...reviews and determine program improvements. + Develop and implement utilization review policies and procedures in accordance… more
- UPMC (Pittsburgh, PA)
- …remote Medical Director, Utilization Management role. The Medical Director, Utilization Management is responsible for assuring physician commitment and ... remote role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including concurrent,… more
