- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …leadership, teamwork, and communication skills. ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical ... of candidates. Education Associates Degree preferred Minimum Work Experience Utilization Review experience preferably in a behavioral/psychiatric healthcare… more
- Amity Foundation (Tucson, AZ)
- …community building. Remembrance, Resolution, Reconciliation, Restoration, Renewal Job Summary: As the Utilization Review Specialist , you will contribute to ... objectively under pressure generated by association with substance abuse students. Title: Utilization Review Specialist Reports To: Dragonfly Program… 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 ... Supervisor, supporting the agency's mission and client care quality. Department Utilization Review Employment Type Full-Time Minimum Experience Mid-level… more
- Hackensack Meridian Health (Hackensack, NJ)
- The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... population and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- Medical Center Hospital (Odessa, TX)
- Position Summary: The Utilization Review Specialist /Outcomes Specialist conducts concurrent and retrospective review functions in support of the ... hospital Utilization Review Program and makes appropriate referrals to designated Physician Advisors. Education: Holds a current Texas license as a Registered… more
- Emory Healthcare/Emory University (Duluth, GA)
- …+ Ongoing mentorship, _development,_ and leadership programs + And more **Description** The Utilization Review (UR) Specialist is responsible for conducting ... with the attending physician and/or physician advisor. + The UR Specialist will perform utilization review by completing a timely and comprehensive … more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is ... responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD)… 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 ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Spectrum Billing Solutions (Skokie, IL)
- …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR ... admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for… more
- Great River Health (West Burlington, IA)
- …browser Qualifications + 4-6 years clinical experience Required + Previous experience in Utilization Review Preferred + Knowledge of the structure and content of ... responsible for maintaining compliance with the CMS Conditions of Participation for Utilization Management.What you will do + Review inpatient encounters for… more
- Nuvance Health (Danbury, CT)
- …other duties as required. Education: ASSOCIATE'S LVL DGRE Preferred- Two Years Utilization Review Experience Required- Registered Nurse ( RN) Working Conditions: ... *Description* Summary: Required- Registered Nurse ( RN) The purpose of the Utilization Management Nurse is to support the physician, the interdisciplinary team, and… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties ... include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency...of care that may be covered. + Monitors all utilization reports to assure compliance with reporting and turnaround… more
- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a Behavioral Health Utilization Review Specialist you want with your current ... group of colleagues. Do you want to work as a Behavioral Health Utilization Review Specialist where your passion for creating positive patient interactions… more
- Catholic Health Initiatives (Omaha, NE)
- …innovative healthcare delivery system. **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding ... patients. **This position offers the flexibility to work remotely with proven Utilization Review experience.** Medical Coding experience is a plus! As our … more
- Community Health Systems (Franklin, TN)
- …to secure timely authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist . + Monitors and updates case ... **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The (per diem) Utilization Review Specialist coordinates scheduling of all surgical/endoscopic hospital admissions, pre-admission testing ... and operating room procedures. This individual seeks the assistance of the Nurse Manager in identifying cases, which require pre admission screening or have questionable admission criteria. **Qualifications** + 1-2 years related healthcare administrative… 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 Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Vanderbilt University Medical Center (Lebanon, TN)
- …that the appropriate admission status is ordered. Conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary ... difficulty. * Clinical Applications Systems (Novice): Possesses fundamental proficiency in utilization review systems, clinical support systems and business… more
- Penn Medicine (Lancaster, PA)
- …day. Are you living your life's work? Summary: + Position Summary: The Utilization Management Specialist - Denials is responsible for evaluating medical records ... without reasonable accommodation to perform the following duties: + Complete chart review and communicate patient status medical needs with insurance companies in… more
- Sanford Health (SD)
- …level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to assure ... relating to determination of medical necessity, authorization, continued stay review including diagnosis and procedural coding for working diagnosis related… more
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