- Henry Ford Health System (Warren, MI)
- The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and resolution ... well-being of our team members is our priority. That's why we offer support in the various components of our team's well-being: physical, emotional, social,… 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
- Marshfield Clinic (Marshfield, WI)
- …to support the most exciting missions in the world!** **Job Title:** Utilization Review Specialist (Remote Option in Wisconsin) **Cost Center:** ... work available for Wisconsin residents only_** **JOB SUMMARY** The Utilization Review Specialist , Revenue Cycle...methods, tools, and techniques and ability to create and support an environment that meets the quality goals of… more
- Nuvance Health (Danbury, CT)
- …other duties as required. Education: ASSOCIATE'S LVL DGRE Required: 3 Years of Utilization Review experience(or a certification ACMA, MCG, Interqual) Required : ... (2nd week) ; rotate one weekend per month Summary: 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 ... Officer/Medical Director as appropriate. + Coordinates an interdisciplinary approach to support continuity of care. + Provides utilization management, transfer… 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: ... County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose....net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,… more
- WellSpan Health (York, PA)
- …Provides feedback to payer contracting regarding payer actions that cause barriers to the utilization review process. + Maintains up to date tip sheet on ... timely notification and communication of pertinent clinical data to support admission, clinical condition, and continued stay. Assists with...assigned payer/payers utilization review process. **Common Expectations:** + Maintains… more
- Catholic Health Initiatives (Omaha, NE)
- **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and optimize ... our patients. **This position offers the flexibility to work remotely with proven Utilization Review experience.** Medical Coding experience is a plus! As our… more
- Ascension Health (Pensacola, FL)
- …process. + Serve as content specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation. + ... **Details** + **Department: Utilization Review ** + **Schedule: Full time...promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans… more
- LifePoint Health (Louisburg, NC)
- Registered Nurse (RN) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound commitment to ... of those we serve. Connect with our RN recruiting specialist . Do you need more time to complete an...the responsibilities involved in monitoring adherence to the hospital's utilization review plan, which ensures the appropriate… more
- Commonwealth Care Alliance (Boston, MA)
- … Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for ... Knowledge, Skills & Abilities (must have): * Expertise in managing utilization review processes including prior authorization, concurrent and retrospective… more
- Intermountain Health (Las Vegas, NV)
- …1-3 are a must in order to be considered for the position.** Performs medical review activities pertaining to utilization review , claims review , quality ... with MG clinicians, Affiliate Network PCPs and Specialists in the community, utilization management, care management, claims, network management, and finance. As the… more
- Colorado State University (Fort Collins, CO)
- …Individual works at the Pentagon in Washington DC. The Natural Resources-Range Management Specialist will provide technical support to the Secretary of the Air ... ensure the general public's understanding of noise impacts. The Specialist will provide review and analysis of... support of natural/cultural resources and climate; Provide support for implementation and utilization of the… more
- CUNY (New York, NY)
- Academic Student Support Specialist **POSITION DETAILS** The CUNY School of Medicine (CUNY SoM) located in the heart of Harlem, New York, is the only medical ... of Student Affairs is currently seeking a Academic Student Support Specialist . This position will play a...staff, and other service providers to monitor and assess utilization , student progress, and program effectiveness - Performs related… more
- Entergy (Beaumont, TX)
- …in the operating processes, practices, standards, and procedures required to support material availability. The Material Management Specialist is considered ... and oversees all the backorder MR's. The Material Management Specialist is responsible for the overall support ...the management of EDC transportation. Help maintain EDC equipment utilization and maintenance log. + Monitor quality control of… more
- UPMC (Pittsburgh, PA)
- …while also considering outcomes of the programs. + Develop and conduct Drug Utilization Review (DUR) activities, Medication Therapy Management (MTM), and other ... UPMC Health Plan is hiring a full-time Clinical Pharmacy Specialist to support the Care Management team...The clinical pharmacist assists in the management of pharmacy utilization and provides expertise in managing member care. These… more
- Integra Partners (Troy, MI)
- …do whatever it takes to get things done. PREFERRED SKILLS: + Certification in Utilization Review or Case Management + Experience with health insurance operations ... our Operations Training & Development team as an Operations UM Training Specialist , specializing in Utilization Management (UM) processes. The ideal candidate… more
- Commonwealth of Pennsylvania (PA)
- County Children Youth Families Program Specialist 2, Quality Assurance (LG) - Blair Co C&Y Print ... (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4975434) Apply County Children Youth Families Program Specialist 2, Quality Assurance (LG) - Blair Co C&Y… more
- HCA Healthcare (Henderson, NV)
- …management, sales, leadership, training, and technology skills, the Consulting Provider Solutions Specialist role works with an integrated support team to ... and responding to, triaging, and delivering seamless coordination for provider support needs. The Consulting Provider Solutions Specialist will maintain… more
- HCA Healthcare (Dallas, TX)
- …this opportunity compelling, we encourage you to apply for our Clinical Pharmacist Specialist BMT PRN opening. We promptly review all applications. Highly ... **Description** **Clinical Pharmacist Specialist BMT** **BMT Experience required** **PRN Position** **Introduction**...Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny… more