- Premera Blue Cross (Mountlake Terrace, WA)
- …management. + Participate in the development, annual review , and approval of company medical review criteria as a member of the Premera Medical Policy ... experienced **MD** to join our team as an **Assistant Medical Director ( Utilization Management - Oncology)** ....to support ongoing education for all clinicians involved in medical review . + Provide professional advisement to… more
- Commonwealth Care Alliance (Boston, MA)
- …for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager...**Essential Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety… more
- Prisma Health (Maryville, TN)
- …of care and timely implementation of plan of care in accordance with hospital(s) Utilization Review Plan and CMS regulation. Maintains expert level knowledge of ... regarding payor and regulatory guidelines. Promotes effective and efficient utilization of clinical resources, ensuring quality, cost effective care. Provides… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... toward that end, to avoid duplication and misuse of medical services, control costs by reducing inefficient services, and...team members; arranges follow up care as appropriate. + Utilization Review -- Reviews prospectively, concurrently and… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... provide requested clinical and psychosocial information to assurereimbursement. + Utilization Review -- Reviews prospectively, concurrently and retrospectively… more
- Terumo Medical Corporation (Somerset, NJ)
- …Req ID: 4839 Location: Somerset, NJ, US, 08873 Company: Terumo Medical Corporation Department: Field Inventory Management **Job Summary** Field Inventory Specialist ... include loaners, consignment, trunk stock. Field Inventory Specialist will ensure effective utilization of assets and compliance with terms of agreements as well as… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...patients who were readmitted within thirty days. Documents over utilization of resources and services. + All Medicare cases… more
- Commonwealth Care Alliance (Springfield, MA)
- …success. + Conduct regular provider meetings (virtual and in-person) to review performance, discuss program updates, and address operational challenges. + Represent ... + Lead the monitoring and analysis of provider performance using utilization , quality, and member experience metrics. + Collaborate with Business Intelligence,… more
- Battelle Memorial Institute (Norfolk, VA)
- …development. Additionally, the specialist refers SOF personnel to appropriate medical providers for new or undiagnosed conditions, provides expert instruction, ... + Refer all personnel with a new or undiagnosed medical condition to a medical provider for...and conditioning equipment + Participate in periodic meetings to review and evaluate physical training programs and identify opportunities… more
- CoxHealth (Lake Spring, MO)
- …responsible for facilitating timely and accurate physician documentation in the medical record through concurrent chart review . Interdisciplinary communication ... team regarding proper clinical documentation utilizing approved guidelines. Understand and utilization of ICD-10-CM and PCS coding assignment and follow Official… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …to enhance understanding of criteria application, benefit use, and the appeal, External Medical Review (EMR), and Fair Hearing processes + Coordinate: Ensures ... results-driven **UM RN Appeals Coordinator.** This role collaborates with clinical review staff, medical directors/physician reviewers, network physicians, and… more
- Battelle Memorial Institute (Sneads Ferry, NC)
- …for further action + Maintain accurate and current notes in patient medical records and produce evaluation and treatment reports as required + Oversee ... referring providers, integrating neuropsychological data, neuro-imaging findings, laboratory data, medical and psychiatric history, and presenting complaints + Monitor… more
- Battelle Memorial Institute (Colorado Springs, CO)
- …within the ATC's scope of practice + Participate in periodic meetings to review the care provided to patients to identify opportunities for improvement. If not ... present, review meeting notes/information. + Serve as an advisor to...participate in meetings with other POTFF staff members and medical personnel as requested and/or required + Assist the… more
- Battelle Memorial Institute (Oceanside, CA)
- …and injury prevention, and ensures all personnel with new or undiagnosed medical conditions are referred to appropriate medical providers. Additionally, the ... + Refer all personnel with a new or undiagnosed medical condition to a medical provider for...and conditioning equipment + Participate in periodic meetings to review and evaluate physical training programs and identify opportunities… more
- ERP International (Luke AFB, AZ)
- …and 5:00pm, including a one hour lunch **Core Duties:** - Participate in Utilization Management/Case Management meetings to review and identify opportunities to ... for a Full-Time position in support of the **56th Medical Group, Luke AFB AZ (https://www.airforcemedicine.af.mil/MTF/Luke/About-Us/)** **.** Apply online today… more
- ENTRUST Solutions Group (Minneapolis, MN)
- …scheduling and work assignment performance in order to forecast resource utilization for upcoming quarter and identify opportunities for resource reallocations and ... operational improvements. + Facilitate monthly regional/area metric review meetings to evaluate performance. + Communicate and work effectively with local… more
- Stony Brook University (Stony Brook, NY)
- …the use of UHIS (Cerner) and LIS (Clinisys & CoPath) order entry and result review screens, new tests additions to the test menu, upgrades to current systems, and ... assigned. + Responsible for daily and monthly monitoring (including documenting monthly review ) of the Rees Temperature Monitoring System for Immunology or Flow… more
- Carnegie Mellon University (Pittsburgh, PA)
- …asset and space data, improving F&A rate accuracy, audit readiness, and utilization reporting. + Proactively identify control gaps in physical inventory processes ... uncover trends, inform leadership decisions, and enhance transparency in asset utilization and financial reporting. + Establish KPIs for asset lifecycle performance,… more
- Stanford Health Care (Palo Alto, CA)
- …and compliance. Areas of responsibility managing a portfolio of contracts covering medical supplies, non- medical supplies, and purchased services with a focus ... for changes in process and operations to include standardization and utilization of resources (supplies, equipment, services, people, etc.). The Category Manager… more
- Stony Brook University (Stony Brook, NY)
- …products /services as required. + Assist with clinical in-service education on correct utilization of medical devices. + Participate in BME projects as assigned. ... Stony Brook Medicine, the **Biomedical Engineering Technician** ensures that medical equipment is well-maintained, safely functional and properly configured.… more
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