- Truman Medical Centers (Kansas City, MO)
- …log into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Specialist 101 Truman Medical Center **Job ... training, coaching and consulting to outside organizations. **Job Description** The Utilization Specialist will verify all financial and insurance information,… more
- AdventHealth (Tampa, FL)
- …Stroke Association as a Primary Stroke Center. **The role you'll contribute:** The Utilization Management (UM) Specialist works under the direction of ... care tower which will ensure state of the art medical and surgical car for generations to come ....the Utilization Management Manager and supports the Utilization … more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN...requests by Providers. Acts as a department resource for medical service requests /referral management and processes.… 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 ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...requests by Providers. Acts as a department resource for medical service requests /referral management and processes.… more
- FLACRA (Clifton Springs, NY)
- UTILIZATION MANAGEMENT SPECIALIST Finger...and values, the Utilization Management Specialist is responsible for evaluation of the medical ... behavioral health setting. + Valid NYS Drivers' License. + Knowledge of utilization management practices. + Strong interpersonal communication skills. + General… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **Job Summary** The Manager Utilization Review/ MediCal Specialist will develop and maintain a full ... of care from pre-admission through post-discharge for Medi-Cal patients. The Manager Utilization Review/ MediCal Specialist will manage the program to… more
- Cleveland Clinic (Cleveland, OH)
- …with one of the most respected healthcare organizations in the world. As an RN Utilization Management (UM) Specialist , you will perform UM activities which ... a minimum of 85% on IRR quarterly. + Completes Utilization Management for assigned patients with a...as a Registered Nurse. + Prior Utilization Management experience is preferred. + Knowledge of medical… 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:** +...appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and… more
- FLACRA (Clifton Springs, NY)
- PER DIEM UTILIZATION MANAGEMENT SPECIALIST Finger Lakes Area Counseling & Recovery Agency Clifton Springs, NY (Onsite) Per Diem Apply Now ... one year of work experience in the behavioral health field with knowledge of utilization management practices. Valid NYS Drivers' License. Get job alerts by… more
- Sanford Health (Bemidji, MN)
- …Summary** Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance ... utilization and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for… more
- Corewell Health (MI)
- …status. + Utilizes electronic medical record work queues that support Utilization Management functions. + Answers incoming calls or places outbound calls ... to obtain authorization numbers for payment. + Provides clerical support for Utilization Management ; sorting faxes and mail, obtaining authorization numbers,… more
- Amity Foundation (Tucson, AZ)
- …individual is responsible for performing a variety of concurrent and retrospective utilization management -related reviews and functions and for ensuring that ... to teach, learn and join our community as a Utilization Review Specialist at our campus in...determined by the DSM V. + Accurately document the medical necessity and level of care based on evidence-based… more
- Veterans Affairs, Veterans Health Administration (Johnson City, TN)
- Summary As the Acquisition Utilization Specialist you will serve as the medical center liaison and advisor on contract related services focusing on critical ... of items to include specialized services. Responsibilities As the Acquisition Utilization Specialist you will serve as the medical center liaison and advisor… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …an interdisciplinary approach to support continuity of care. + Provides utilization management , transfer coordination, discharge planning, and issuance of ... The UR Specialist reviews and monitors patients' utilization ...high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate… more
- HonorHealth (Scottsdale, AZ)
- …communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... Facilitates the delivery of services to patients and families through effective utilization of available resources. Performs medical record reviews, as required… more
- Spectrum Billing Solutions (Skokie, IL)
- …cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR Specialist ... Responsibilities include: + Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. +… more
- University of Virginia (Charlottesville, VA)
- As a Medication Utilization , Formulary, and Policy Specialist , you will play a crucial role in optimizing medication management practices UVA. The primary ... position is to manage the completion of formulary activities, support medication utilization projects, and ensure timely policy management within the department… more
- Hawaii Pacific Health (Honolulu, HI)
- …Services, which provides Hawai'i Pacific Health and its affiliates essential population utilization and financial management support, analyses and modeling. The ... referral management , patient steerage, and claims auditing. As the Specialist , you will be responsible for providing comprehensive managed care information… more
- University of Washington (Seattle, WA)
- …. RN2, Utilization Management ... will have partial/variable involvement with Harborview's Emergency Department. The Utilization Management Specialist RN2 is...of patients through the use of approved indicators and medical criteria to ensure that standards of quality and… more
- Robert Half Office Team (Monterey Park, CA)
- Description The Utilization Management Nurse Specialist LVN promotes the quality and cost effectiveness of medical care by applying clinical acumen and ... on case findings. Functions & Job Responsibilities * The Utilization Management Nurse Specialist LVN...holidays depending on business needs * Educate providers on utilization and medical management processes… more