- 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...information and advocating for appropriate levels of care. The UR Specialist works closely with clinical staff,… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services ... and collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital … more
- Parkview Health (Fort Wayne, IN)
- …installing systems to obtain precertification and recertification for payment and utilization review . Attends treatment planning to advise regarding ... assurance experience preferred. Other Qualifications Application of and use of review criteria related to clinical evaluation of appropriate levels of psychiatric… more
- Community Health Systems (Franklin, TN)
- …to secure timely authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist . + Monitors and updates case ... **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and… more
- HonorHealth (AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, 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 include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency...of care that may be covered. + Monitors all utilization reports to assure compliance with reporting and turnaround… more
- Trinity Health (Athens, GA)
- **Employment Type:** Part time **Shift:** **Description:** The Utilization Review ( UR ) Coordinator works, in collaboration with a multidisciplinary team that ... management and auditing duties as assigned. Participates in the Utilization Review Committee as assigned. Maintains good...their healthcare consumers, their peers and to society. The UR Specialist is recognized as an expert… more
- University of Rochester (Rochester, NY)
- …any investigations and corrective action plans as it relates to HazD handling and utilization within the health system. Documents the review of the quality ... 40 Department: 100124 Environmental Health & Safety Work Shift: UR - Day (United States of America) Range: ...UR - Day (United States of America) Range: UR URG 111 Compensation Range: $63,815.00 - $95,723.00 _The… more
- LifePoint Health (Hickory, NC)
- …and regulatory requirements (Joint Commission, OSHA, CMS, HCFA, AHCA). * Mentors staff on Utilization Review ( UR ) standards and Length of Stay (LOS) topics. ... of those we serve.** *Connect with our RN recruiting specialist * Not ready to complete an application, or have...outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources,… more