- Penn State Health (Hershey, PA)
- …###@pennstatehealth.psu.edu (MAILTO://###@pennstatehealth.psu.edu) Penn State Health is seeking a dedicated ** Utilization Management Specialist ** to join our ... SEIU Healthcare Pennsylvania **Position** Specialist (Part-time) - VARIED SHIFTS - Utilization Management **Location** US:PA: Hershey | Nursing | Part Time… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...Nursing Experience Required: At least 5 years of varied clinical experience in an acute hospital setting. At least… more
- BriteLife Recovery (Englewood, NJ)
- …compliance. + Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials, approvals, ... What you will be doing? The Utilization Review (UR) Specialist is a...and advocating for appropriate levels of care. The UR Specialist works closely with clinical staff, admissions,… more
- Penn Medicine (Lancaster, PA)
- …each day. Are you living your life's work? Summary: + Position Summary: The Utilization Management Specialist - Denials is responsible for evaluating medical ... insurance benefit structures and related legal medical issues. + Knowledge of utilization management and quality improvement processes. + Experience working… more
- Trinity Health (Stafford Springs, CT)
- …time **Shift:** Day Shift **Description:** RN or Social Worker **Position Purpose** The Utilization Management Specialist is responsible for acute care ... (Medical Records) and Admitting, to provide pertinent data relating to utilization management / clinical resource management issues and questions… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing… more
- Sanford Health (SD)
- …Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to ... utilization and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for… more
- Spectrum Billing Solutions (Skokie, IL)
- …cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR Specialist ... will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for behavioral healthcare services. The… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …an interdisciplinary approach to support continuity of care. + Provides utilization management , transfer coordnation, discharge planning, and issuance of ... The UR Specialist reviews and monitors patients' utilization ...and quality of care. + Responsible for the proactive management of patients with the objective of improving quality… more
- HonorHealth (Scottsdale, AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of ... urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization,… more
- St Joseph's Addiction Treatment & Recovery Centers (Saranac Lake, NY)
- …Centers Location: Inpatient Facility - Saranac Lake, NY Position: Full-time Utilization Review Specialist Shift/schedule: Monday-Friday, 8:00am-4:30pm Pay Range: ... literate with strong proficiency in Microsoft applications, and knowledgeable of clinical documentation systems. ability to make appropriate decisions based on… more
- Hackensack Meridian Health (Hackensack, NJ)
- …include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management , and transitions of care, as outlined in ... The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of … more
- Nuvance Health (Danbury, CT)
- … outcomes while managing the cost of care and providing timely and accurate clinical information to payors. Utilization management provides clinically based ... Required- Registered Nurse ( RN) The purpose of the Utilization Management Nurse is to support the...discuss case with the attending MD to gather additional clinical information and request additional documentation to support inpatient… more
- Philips (Fort Lauderdale, FL)
- **Sales Support, Clinical Specialist - Heart Rhythm Management - Image Guided Therapy Devices (South Florida)** As a Clinical Specialist with our ... Lead Management team you will provide clinical expertise and organic revenue generation and growth to...Provider Education efforts, and help drive full product portfolio utilization to meet the needs of our customers. **Your… more
- HCA Healthcare (Richmond, VA)
- **Description** **Introduction** Do you have the PRN career opportunities as a Clinical Rehab Specialist PRN you want with your current employer? We have an ... of colleagues. Do you want to work as a Clinical Rehab Specialist PRN where your passion...screenings and assessments in collaboration with both hospital Case Management and the Rehab Medical Director and works closely… more
- HCA Healthcare (Dallas, TX)
- …includes monitoring patient medication regimens and providing appropriate interventions. The Clinical Specialist shall also assist in mentoring pharmacy staff ... **Description** ** Clinical Pharmacist Specialist BMT** **BMT Experience...defined by Pharmacy Leadership. Develop, manage and mentor antimicrobial management program (AMP). + Documents all clinical … more
- HCA Healthcare (St. Petersburg, FL)
- **Description** **Introduction** Do you have the career opportunities as a(an) Pharmacy Clinical Specialist Pharmacist you want with your current employer? We ... colleagues. Do you want to work as a(an) Pharmacy Clinical Specialist Pharmacist where your passion for...defined by Pharmacy Leadership. Develop, manage and mentor antimicrobial management program (AMP). + Documents all clinical … more
- Intermountain Health (Las Vegas, NV)
- …Utilization Management , you are responsible, in partnership with MG Clinical Leadership, for the appropriate utilization of medical services within ... clinicians, Affiliate Network PCPs and Specialists in the community, utilization management , care management , claims,...Leaders at Intermountain Nevada who set the course for Clinical Care and Care Management Initiatives here.… more
- HCA Healthcare (San Antonio, TX)
- …includes monitoring patient medication regimens and providing appropriate interventions. The Clinical Specialist shall also assist in mentoring pharmacy staff ... **Introduction** Do you have the career opportunities as a(an) Clinical Pharmacist Specialist you want with your...multidisciplinary and bedside rounds + You will complete drug utilization reviews to promote rational drug therapy and implement… more
- HCA Healthcare (Nashville, TN)
- …includes monitoring patient medication regimens and providing appropriate interventions. The Clinical Specialist shall also assist in mentoring pharmacy staff ... Do you have the PRN career opportunities as a(an) Clinical Pharmacist Specialist BMT Oncology PRN you...multidisciplinary and bedside rounds + You will complete drug utilization reviews to promote rational drug therapy and implement… more
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