- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for receiving/reviewing… more
- HCA Healthcare (Dublin, GA)
- **Description** **Introduction** **Clinical Rehab Specialist ( Admissions Coordinator/ Liaison )** Do you want to join an organization that invests in you as a ... **Clinical Rehab Specialist ( Admissions Coordinator/ Liaison )** ? At Fairview Park Hospital,...screenings and assessments in collaboration with both hospital Case Management and the Rehab Medical Director. The Clinical Rehabilitation… more
- University of Pennsylvania (Philadelphia, PA)
- …This position has multifaceted functions responsible for managing Slate, the Admissions Customer Relations Management (CRM) system that processes all ... ensure compliance with institutional privacy policies. As the school's liaison for Graduate Admissions User Groups and...A Bachelor's degree with 3-5 years of experience in admissions operations, enrollment management , or higher education… more
- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500016 Admissions Center-SMH Work Shift: UR - Rotating (United States of America) Range: ... **Responsibilities:** GENERAL SUMMARY Coordinates or manages inpatient and outpatient admissions , including bed assignments and the completion of preliminary… more
- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500016 Admissions Center-SMH Work Shift: UR - Rotating (United States of America) Range: ... financial eligibility, secures account for billing and coordinates account management through discharge Completes appropriate forms to complete Death Certificate… more
- Ochsner Health (New Orleans, LA)
- …(CCM), Certified Professional Utilization Review (CPUR), Certified Professional in Utilization Management (CPUM) or Certified Professional in Healthcare ... in the delivery of patient care. Preferred - Experience in case management or utilization review. **Certifications** Required - Current Registered Nurse… more
- Wellpath (Lemoyne, PA)
- … utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and stakeholders, and ... **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization...to reduce length of inpatient stays and decrease ED admissions . + Evaluate and recommend policy improvement related to… more
- Sutter Health (Berkeley, CA)
- …systems for the appeal/denial process, tracks and trends data, and coordinates utilization management activities for the assigned area. Collaborates with ... of services and appropriate service reimbursement. Monitors and acts as a liaison between external payers, internal business office, admissions staff, and… more
- Somatus (Baltimore, MD)
- …accessing resources to adhering to a physician's treatment plan upon discharge. The Hospital Liaison will work with the RNCM, case management and care givers to ... leadership and/or provider engagement to build relationships with case management teams at strategic facilities in assigned area as...ongoing conversations and plans to address areas to reduce admissions and cost utilization + Other duties… more
- Ochsner Health (New Orleans, LA)
- …as well as efficiently in high pressure situations. Preferred- Experience in Case Management or Utilization Review Business and Financial Knowledge as well as ... and applies hospital approved medical necessity criteria to review appropriate admissions , levels of care and continued stay. Documents completed reviews in… more
- Tenet Healthcare (Detroit, MI)
- …also, a working knowledge of the revenue cycle and resulting impact of utilization management decisions. 3. Interpersonal skills to work productively with all ... Clinical Liaison Referral Services Full Time Days - 2506001476...and procedures, acts as a member of the care management team by applying medical necessity criteria to determine… more
- Sharp HealthCare (San Diego, CA)
- …with Rehab Medical Director and other Physicians regarding potential patient admissions . + Data Management Effectively monitors, collects, and reports ... management systems to monitor referral source patterns and utilization . Reports activity by referral source; and appropriately/strategically adjusts plans to… more
- Beth Israel Lahey Health (Plymouth, MA)
- …unit cost, 4) reducing readmissions. **Duties/Responsibilities:** **A. Utilization Management ** Performs review of anticipated admissions utilizing InterQual ... This role is structured around four major functions + Utilization Management + Care Coordination + Discharge...satisfaction with the discharge from the ED Prevents unnecessary admissions for social reasons Functions as a liaison… more
- Ventura County (Ventura, CA)
- …medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality Assurance Staff. + Participates, as ... surgical procedures, referrals, tests, medication approvals requiring authorization.) + Develops utilization management standards and guidelines for approval by… more
- Bassett Healthcare (Cooperstown, NY)
- …do The Logistics C3 RN is responsible for appropriate placement for patient admissions , coordinating and expediting admissions and transfers as well as ... Bassett Medical Center and throughout the network. Acts as a primary liaison between all service locations, support departments, other healthcare facilities, and in… more
- Mount Sinai Health System (New York, NY)
- …limited to: a. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using ... **Job Description** **RN/Case Manager MSH Case Management PT Days** The Case Manager (CM) will...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
- Catholic Health Initiatives (Omaha, NE)
- …physician serving the hospital through teaching, consulting, and advising the care management and utilization review departments, medical staff members, and the ... continued stay reviews + Assist with length of stay management and utilization of resources + Assist...quality control, and patient safety + Act as a liaison with payers to facilitate approvals and prevent denials… more
- Logan Health (Kalispell, MT)
- Logan Health Wellness & Pain Management is proud to offer some of the most comprehensive pain and wellness care in the United States. Job Description Summary Logan ... Health Wellness and Pain Management is looking for an LCSW, LCPC or LMFT...Duties: + Triages referrals from providers and ensures on-going liaison occurs with stakeholders as applicable to assigned area(s).… more
- Community Health Systems (Franklin, TN)
- …preferred **Knowledge, Skills and Abilities** + Strong knowledge of utilization management principles, payer requirements, and healthcare regulations. ... Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and appeals… more
- HCA Healthcare (Houston, TX)
- …other third party payers in accordance with procedures set forth in the Hospital Utilization Management Plan and the criteria and standards approved by the ... and assigning extended stays in accordance with criteria approved by the Utilization Management Committee and Medical Staff with referral of all cases… more