- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Utilization Review / Quality Assurance Coordinator is responsible for all compliance related paperwork and ensures all compliance ... paperwork is completed in a timely manor for the Upstate/Syracuse City School District school-based mental health care program. This position helps ensure successful visits by DNV and OMH when they occur. Monitors and maintains performance improvement… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Utilization Review / Quality Assurance Sr. Coordinator will be responsible for providing clinical information to managed care companies as ... regulatory agencies, and other health care related entities. Preferred Qualifications: Utilization Review /Managed Care/ Quality Assurance experience.… more
- WMCHealth (Valhalla, NY)
- …hospital or health care agency, one of which must have been in the area of utilization review , quality assurance , risk management or discharge planning. ... the implementation or investigation of the procedures specified in the Quality Management, Utilization Review and Discharge Planning Program at Westchester… more
- Intermountain Health (Las Vegas, NV)
- …medical review activities pertaining to utilization review , claims review , quality assurance , and medical review of complex, controversial, ... timely documentation and reporting. + Demonstrated knowledge of case management, utilization management, quality management, discharge planning, and other cost… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity… more
- BAYADA Home Health Care (Orlando, FL)
- …should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance , Remote, Home Health ... Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding ...monitoring Outcome and Assessment Information Set (OASIS) documentation for quality and adherence to policies and procedures. As a… more
- BAYADA Home Health Care (Orlando, FL)
- …with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance , Remote, Home Health Coding, ... Home Health Care has an immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work remotely. RN, PT, OT, and… more
- Beth Israel Lahey Health (Burlington, MA)
- …coordinates utilization review , discharge planning and monitors quality assurance for Lahey Clinic inpatient admissions. Leads the multidisciplinary ... in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital...needed. 10) Supports all service line activities related to utilization and quality management. 11) Assists in… more
- Centene Corporation (Columbus, OH)
- … quality improvement activities. + Performs medical review activities pertaining to utilization review , quality assurance , and medical review ... + Provides medical expertise in the operation of approved quality improvement and utilization management programs in...with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends… more
- Bon Secours Mercy Health (Toledo, OH)
- …**Work Experience** 3 years' experience in clinical health care patient accounting, admitting, utilization review , quality assurance or case management ... 5 years' experience in clinical health care patient accounting, admitting, utilization review , quality assurance or case management (preferred)… more
- MTC (Bryan, TX)
- …co-dependency, and related disorders. 2. Performs complex technical assistance work; implements quality assurance utilization review procedures; and ... and procedures. 3. Assists in monitoring, reviewing, interpreting, and evaluating quality of services; assists in compiling and analyzing data and preparing… more
- University of Maryland, Baltimore (Baltimore, MD)
- …Directs activities related to the delivery of medical care and clinical services such utilization review , quality assurance , policies, procedures and ... operational, and leadership skills and experience in neonatal care, quality , and safety to lead the clinical service. The...clinical and reimbursement activity. 7. Participates in the Peer Review Program as described in the Medical Staff Bylaws… more
- Matrix Providers (Aurora, CO)
- … Quality and Management (HCQM) through American Board of Quality Assurance and Utilization Review Physicians (ABQARP) + Certified Informatics Nursing, ... Utilization Review Nurse (RN) Location: Aurora,... Utilization Management Accreditation through National Committee for Quality Assurance (NCQA) are desired. Experience: Minimum… more
- CenterLight Health System (Flushing, NY)
- …(5+) years of experience in care/case management, disease management, population health management, utilization review , quality assurance , or discharge ... model. + Escalates questions or concerns during the assessment to the quality review team to ensure appropriate completion of UAS-NY and handling of on-site… more
- FlexStaff (New York, NY)
- …(5+) years of experience in care/case management, disease management, population health management, utilization review , quality assurance , or discharge ... delivery model. Escalates questions or concerns during the assessment to the quality review team to ensure appropriate completion of UAS-NY and handling of… more
- Ochsner Health (New Orleans, LA)
- …(ACPA) or (2) Board Certification by the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) or (3) Physician Advisor ... Sub-Specialty Certification by the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) or (4) commitment to apply for such… more
- Actalent (White Plains, NY)
- …(5+) years of experience in care/case management, disease management, population health management, utilization review , quality assurance , or discharge ... model. + Escalate questions or concerns during the assessment to the quality review team to ensure appropriate completion of UAS-NY and handling of on-site… more
- Actalent (Queens, NY)
- …Qualifications + Experience with care/case management, disease management, population health management, utilization review , quality assurance , or ... model. + Escalate questions or concerns during the assessment to the quality review team to ensure appropriate completion of UAS-NY and handling of on-site… more
- ManpowerGroup (Columbia, SC)
- …of an Accredited School of Nursing. + 2 years clinical experience plus 1 year in utilization /medical review , quality assurance , or home health. + An ... their team. As an Analyst, Appeals, you will be part of the clinical review department supporting the appeals team. The ideal candidate will have strong analytical… more
- FlexStaff (Tarrytown, NY)
- …(3-5) years of experience in care/case management, disease management, population health management, utilization review , quality assurance , or discharge ... and referral sources through various channels. + Escalates assessment-related concerns to quality review for proper UAS-NY completion and issue resolution. +… more
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