- Immigration and Customs Enforcement (IN)
- …Director for Healthcare Compliance, Office of Health Plan Management. The Senior Utilization Review Consultant will report directly to the IHSC Regional ... Responsibilities DUTIES AND RESPONSIBILITIES: Serves in the capacity of Senior Utilization Review Consultant and subject matter expert in program activities and… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… more
- Children's Mercy Kansas City (Kansas City, MO)
- …lives of children beyond the walls of our hospital. Overview The Manager of Utilization Review will provide leadership to integrated inpatient teams and assist ... as well as training/oversight of programs and services. Responsible for effective utilization review and proper resource management, including patient statusing… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Physician Specialist collaborates with the healthcare team in the management and resolution of activities that assure ... patient population and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- Beth Israel Lahey Health (Burlington, MA)
- …necessity recommendations, as requested Policy Setting Responsibilities Responsible for utilization review and medical necessity recommendations, as requested ... Decision-Making Authority: Responsible for collaborating with the utilization review department as these issues relate to commercial payers, to meet established… more
- Beth Israel Lahey Health (Burlington, MA)
- …Medical Center is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three ... Description:** **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate, perform and complete assigned duties in providing care to… more
- Beth Israel Lahey Health (Burlington, MA)
- …**Work Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days 8:00am-4:30pm weekend and ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey… more
- Prime Healthcare (Bloomington, IN)
- …Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities The Utilization review tech ... essentially works to coordinate the utilization review and appeals process as part of the denial...appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating… more
- Sutter Health (Berkeley, CA)
- …and others to ensure appropriate utilization and quality care through utilization review , tracking and evaluation and objectively compare criteria with ... clinical nursing staff and other departments regarding documentation required for utilization review activities and processes. Collaborate with medical, nursing… more
- Billings Clinic (Billings, MT)
- …starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE MANAGEMENT ... tuition loan reimbursement Under the direction of department leadership, the Utilization Review / Management RN. This position is to conduct initial, concurrent,… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working Conditions… more
- Prime Healthcare (Bristol, PA)
- …Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities The Utilization review tech ... essentially works to coordinate the utilization review and appeals process as part of the denial...appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating… more
- St. Luke's University Health Network (Bethlehem, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Utilization Review Assistant is responsible for taking the data provided to their ... and using it to communicate necessary information to both the Utilization Review Nurses and insurance companies. Making sure that all necessary information… more
- Munson Healthcare (Traverse City, MI)
- …interdisciplinary team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic work ... Michigan. + Minimum of three years clinical experience required. Previous utilization review and/or case management in a hospital or insurance industry preferred… more
- HCA Healthcare (Largo, FL)
- …Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Utilization Review RN with HCA Florida Largo West Hospital you can ... need to succeed in our organization. We are looking for an enthusiastic Utilization Review RN to help us reach our goals. Unlock your potential! **Job Summary… more
- Albany Medical Center (Albany, NY)
- Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) Utilization Review Nurse Salary Range: $31.28 - $51.61 per hour ... + Basic knowledge of computer systems with skills applicable to utilization review process. + Excellent written and verbal communication skills. + Working… more
- Universal Health Services (Doylestown, PA)
- Responsibilities Foundations Behavioral Health is currently hiring a full-time Utilization Review Coordinator to support our UM Department in Doylestown, PA. ... through discharge, including peer reviews and appeals, in accordance with the Utilization Review Plan, for patient population ages 5 years through 21 years, with… 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:** + Functions as the primary liaison between the funding agents and all… more
- Catholic Health Initiatives (Omaha, NE)
- **Overview** Utilization Review RN is responsible for the review of medical records for appropriate admission status and continued hospitalization. Works in ... 1. Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on… more
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