- Novo Nordisk Inc. (Saddle Brook, NJ)
- …sales and marketing resources to expand the breadth and depth of appropriate utilization Novo Nordisks products, consistent with label and company policy Analyze and ... those individuals Recognize opportunities to productively challenge HCPs clinical management of patients that respects their knowledge and experience...in this job family are as follows: Obesity Care Specialist I - $98K to $120K Obesity Care … more
- Novo Nordisk Inc. (Phoenix, AZ)
- …productively and respectably challenge and influence target physicians' approach to patient management and adds value by sharing new information and unique insights ... appropriate patients that would benefit in order to ensure early trial and utilization Generates advocacy for Novo Nordisk products and services by sharing approved… more
- Merck & Co. (Rahway, NJ)
- Job Description Senior Specialist , Financial Planning and Analysis: Global Capital Planning and Reporting Our Company is committed to be the world's premier, most ... a trusted business partner, playing a critical role in ensuring effective resource utilization , specifically to ensure our Company is spending the right amount on… more
- AdventHealth (Tampa, FL)
- …such as heart failure, cancer and other diseases. **The role youll contribute:** The Utilization Management (UM) Specialist works under the direction of the ... Utilization Management Manager and supports the Utilization ...team with Emergency, Observation and Inpatient visits. The UM Specialist is responsible for providing clerical assistance to the… 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 ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Utilization Management Specialist , Revenue Integrity and Utilization Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: ... to be named a Forbes "Best Employer" seven times. Position Summary: The Utilization Management Specialist I will perform utilization management … more
- Henry Ford Health System (Troy, MI)
- …quality of care provided by the primary care team. He/she works with utilization management reports, corporate data stores, and information services to optimize ... decrease waste, and rework in the region, and improve drug utilization . The Pharmacy Specialist will be instrumental in guiding the further development of other… more
- Sanford Health (Fargo, ND)
- …credit added to wage ** **Department Details** This role will be supporting the Utilization Management team in various administrative tasks. We are seeking a ... financial assistance; prior authorization; track patient/resident visits; health information management on patient/resident accounts; work on weekly and monthly… 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 ... & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible for the… more
- UnityPoint Health (West Des Moines, IA)
- …approved days, denials, requests for further information. + In coordination with RN Utilization Management Specialist , communicate opportunities for Peer to ... Services + FTE/Hours per pay period: 0.8 + Department: Utilization Management + Shift: 7:00-3:30 + Job...established processes. Seeks necessary clinical direction of RN UM Specialist staff or Manager. + Coordinates appropriate and timely… more
- Integra Partners (Troy, MI)
- …to join our Operations Training & Development team as an Operations UM Training Specialist , specializing in Utilization Management (UM) processes. The ideal ... industry standards, regulatory requirements, and best practices in clinical documentation and utilization management and update training documents as required +… more
- BriteLife Recovery (Englewood, NJ)
- …compliance. + Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials, approvals, ... What you will be doing? The Utilization Review (UR) Specialist is a...you? + Minimum of 2-3 years of experience in utilization review, case management , or insurance coordination… more
- Spectrum Billing Solutions (Skokie, IL)
- …cycle management company for healthcare organizations. We are looking to add a Utilization Review Specialist to our growing team. The Utilization Review ... and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for treatment… more
- Baylor Scott & White Health (Dallas, TX)
- …management to provide services to members. + Keep updated on approved utilization management criteria, guidelines, and regulations. **Key Success Factors** + ... use treatment experience and/or behavioral health treatment + Experience with Utilization Management for Substance use treatment experience and/or behavioral… more
- HonorHealth (AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of ... of extended stay, outpatient observation, and inpatient stays and the utilization of ancillary services. Responsible for coordinating and conducting medical… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …an interdisciplinary approach to support continuity of care. + Provides utilization management , transfer coordnation, discharge planning, and issuance of ... The UR Specialist reviews and monitors patients' utilization ...and quality of care. + Responsible for the proactive management of patients with the objective of improving quality… 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:** 101651289 ... **_Remote work available for Wisconsin residents only_** **JOB SUMMARY** The Utilization Review Specialist , Revenue Cycle Provide quality assurance of… 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
- 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 ... to justify acute hospital admission, need for continued stay, and proper utilization of physician, nursing, and ancillary services. Responsible for concurrent review… more
- Nuvance Health (Danbury, CT)
- …(2nd week) ; rotate one weekend per month Summary: The purpose of the Utilization Management Nurse is to support the physician, the interdisciplinary team, and ... of care and providing timely and accurate clinical information to payors. Utilization management provides clinically based first level medical necessity reviews… more
