- Novo Nordisk Inc. (Walnut Creek, CA)
- …the Specialty Field Sales Representative reports to the District Business Manager of the specific sales territory. The Specialty Field Sales Representative ... and unique insights Leverages superior understanding of complexities within the targeted physician customer base in order to maximize performance Applies high level… more
- Sutter Health (Burlingame, CA)
- …the acute care patient experience. This position works in collaboration with the Physician , Utilization Manager , Medical Social Worker and bedside RN ... the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating… more
- Sutter Health (Modesto, CA)
- …the acute care patient experience. This position works in collaboration with the Physician , Utilization Manager , Medical Social Worker and bedside RN ... the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating… more
- Sutter Health (Vallejo, CA)
- …the acute care patient experience. This position works in collaboration with the Physician , Utilization Manager , Medical Social Worker and bedside RN ... the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating… more
- UNC Health Care (Chapel Hill, NC)
- …care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... needs are met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in… more
- Beth Israel Lahey Health (Burlington, MA)
- …Management & review, HIM, Coding & Billing. Close collaboration with the Physician Advisors, Collaborates and helps facilitate the Utilization Review Committee. ... /Managed Care, Physician Advisors Works collaboratively managing the process of Utilization Review throughout the system **As a health care organization, we have… more
- Catholic Health Services (Melville, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... queries from payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record,… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you...causes of denials for discussion with the internal team, physician advisor and the Utilization Review Committee… more
- Covenant Health (Nashua, NH)
- …and procedures. + Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all mandatory learning ... Summary Conducts medical necessity reviews in accordance with the Utilization Management (UM) plan for patients that are housed on a nursing unit, to include… more
- UNC Health Care (Hendersonville, NC)
- …the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review ... met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the...patient data and treatments. Communicates daily with the Care Manager to manage level of care transitions & appropriate… more
- Penn State Health (Hershey, PA)
- …medical or genetic information._ \#LI-TB1 IND567 **Union:** Non Bargained **Position** Manager Utilization Management - Utilization Management **Location** ... the processes. The incumbent is responsible for identifying and communicating utilization management concerns to physician and administrative leadership to… more
- AdventHealth (Glendale Heights, IL)
- …Glendale Heights, IL 60139 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by ... department and regulatory standards. When screening criteria does not align with the physician order or a status conflict is indicated, the UM nurse is responsible… more
- Houston Methodist (Sugar Land, 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, observation progression...prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ... resource to the physicians and provides education and information on resource utilization and national and local coverage determinations (LCDs & NCDs). This position… more
- Alameda Health System (Oakland, CA)
- …requirements. 16. Participate in orientation of fresh staff as requested by the Manager of Utilization Management. 17. Maintains knowledge of current trends and ... System Utilization Management SUM Utilization Review RN...observation, outpatient). 3. Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may not… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review Full Time Days - 2506001796 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients ... to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and right to… more
- Alameda Health System (Oakland, CA)
- …requirements. 16. Participate in orientation of fresh staff as requested by the Manager of Utilization Management. 17. Maintains knowledge of current trends and ... System Utilization Management SUM Specialist + Oakland, CA +...patient class upon admission and providing education to enhance physician understanding of patient classification criteria. **DUTIES & ESSENTIAL… more
- Dignity Health (Carmichael, CA)
- **Responsibilities** **Day Per Diem Utilization Review Registered Nurse - Onsite Campus Position** The ** Utilization Review RN** is responsible for the review of ... In this position the incumbent: + Works in collaboration with the attending physician , consultants, second level physician reviewer and the Care Coordination… more
- LA Care Health Plan (Los Angeles, CA)
- …to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service ... Utilization Management Nurse Specialist RN II Job Category:...cases and reports are maintained and referred to the Physician Advisor/UM Director. Document in platform/system of record. Utilize… more
- Baptist Memorial (Meridian, MS)
- Overview RN Utilization Review Weekender Job Code: 22818 FLSA Status Job Family: NURSING Job Description Title: RN Utilization Review Weekender Job Summary The ... and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance companies… more
