- Truman Medical Centers (Kansas City, MO)
- …log into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Specialist 101 Truman Medical Center **Job ... training, coaching and consulting to outside organizations. **Job Description** The Utilization Specialist will verify all financial and insurance information,… 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 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...requests by Providers. Acts as a department resource for medical service requests /referral management and processes.… more
- FLACRA (Clifton Springs, NY)
- UTILIZATION MANAGEMENT SPECIALIST Finger...and values, the Utilization Management Specialist is responsible for evaluation of the medical ... behavioral health setting. + Valid NYS Drivers' License. + Knowledge of utilization management practices. + Strong interpersonal communication skills. + General… more
- University of Colorado (Aurora, CO)
- …Skills, and Abilities:** + Well-developed knowledge and skills in areas of utilization management , medical necessity, and patient status determination. ... + Attention to detail. + Strong organizational and time management skills. + Excellent writing and editing skills. +...Anschutz Medical Campus is seeking a Medicaid Utilization Review Specialist (full time, University Staff/Non… more
- BayCare Health System (Cotton Plant, AR)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and ... compassionate team. **The Utilization Review Specialist Senior responsibilities include:** +...appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and… more
- FLACRA (Clifton Springs, NY)
- PER DIEM UTILIZATION MANAGEMENT SPECIALIST Finger Lakes Area Counseling & Recovery Agency Clifton Springs, NY (Onsite) Per Diem Apply Now ... one year of work experience in the behavioral health field with knowledge of utilization management practices. Valid NYS Drivers' License. Get job alerts by… more
- Munson Healthcare (Traverse City, MI)
- …of resources. + Assists in developing and revising policies to support utilization management activities, including criteria and guidelines for appropriate use ... colleagues and hospital associates at information meetings. + May represent Utilization Management on various committees, professional organizations, physician… more
- Veterans Affairs, Veterans Health Administration (Fargo, ND)
- Summary The Supervisory Acquisition and Utilization Specialist renders expert contract pre-award and post award expertise to all Administrative and Clinical ... not a virtual position. Position Description/PD#: Supervisory Acquisition and Utilization Specialist /PD99867S Relocation/Recruitment Incentives: Not Authorized Critical… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management /Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides direct assistance to member's with health… more
- Sanford Health (SD)
- …Summary** Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance ... utilization and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for… more
- Veterans Affairs, Veterans Health Administration (New York, NY)
- Summary As the Acquisition Utilization Specialist you will serve as the medical center liaison and advisor on contract related services focusing on critical ... This is not a virtual position. Position Description/PD#: Acquisition & Utilization Specialist /PD99492-S Requirements Conditions of Employment You must be… more
- Amity Foundation (Tucson, AZ)
- …individual is responsible for performing a variety of concurrent and retrospective utilization management -related reviews and functions and for ensuring that ... to teach, learn and join our community as a Utilization Review Specialist at our campus in...determined by the DSM V. + Accurately document the medical necessity and level of care based on evidence-based… more
- Sutter Health (Berkeley, CA)
- …systems for the appeal/denial process, tracks and trends data, and coordinates utilization management activities for the assigned area. Collaborates with ... clinical nursing staff and other departments regarding documentation required for utilization review activities and processes. Collaborate with medical , nursing… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …an interdisciplinary approach to support continuity of care. + Provides utilization management , transfer coordination, discharge planning, and issuance of ... The UR Specialist reviews and monitors patients' utilization ...high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate… more
- Veterans Affairs, Veterans Health Administration (Clarksburg, WV)
- Summary As the Acquisition Utilization Specialist you will serve as the medical center liaison and advisor on contract related services focusing on critical ... This is not a virtual position. Position Description/PD#: Acquisition Utilization Specialist /PD99810-S Relocation/Recruitment Incentives: Not Authorized Financial… 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 ... Responsibilities include: + Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. +… more
- University of Virginia (Charlottesville, VA)
- As a Medication Utilization , Formulary, and Policy Specialist , you will play a crucial role in optimizing medication management practices UVA. The primary ... position is to manage the completion of formulary activities, support medication utilization projects, and ensure timely policy management within the department… more
- Providence (Portland, OR)
- …time **Job Shift:** Day **Career Track:** Business Professional **Department:** 5018 HCS MEDICAL MANAGEMENT OR REGION **Address:** OR Portland 4400 NE Halsey ... empower them._** **Providence Health Plan is calling an Associate Utilization Review Specialist who will:** + Be...Clinical Claims + Provider Reconsideration + Member Appeals + Medical + Coding + Reimbursement Policy + Coordinate and… more
- PeopleReady (CA)
- …usage of agency applications such as Microsoft365, Teams, SharePoint, PowerBI, Case Management and Document Management systems. * Deliver trainings around the ... on processes we are missing in conjunction with the Management staff. * Handle special projects as assigned by...* Accommodations may be requested for a religious or medical exemption from the COVID-19 vaccination requirement. NLACRC Offers… more
- Regis HR Group (Miami, FL)
- …trains and disciplines staff to ensure smooth operations in utilization management . + Also facilitates educational training for medical staff on issues ... Develops, manages and directs the Utilization Management programs for the primary...management solutions. + Creates, manages and updates preferred specialist networks focused on cost-effectiveness and high quality. +… more