- 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 II will...of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM). Knowledge… more
- BayCare Health System (Cotton Plant, AR)
- …more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Specialist Senior **Location** Clearwater:Morton Plant | Clinical | Part ... and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and compassionate… more
- Trinity Health (Maywood, IL)
- …Loyola campus. Position is hybrid, must reside in Illinois. The Regional Utilization Review Documentation Specialist nurse works with the multidisciplinary team ... Serves as a resource to the healthcare team regarding utilization standards and potential alternatives to acute care...+ Strong clinical background is necessary. + Clinical experience in medicine, surgery, critical care ,… more
- FLACRA (Clifton Springs, NY)
- UTILIZATION MANAGEMENT SPECIALIST Finger Lakes Addiction Counseling and Referral Agency Inc Clifton Springs, NY (Onsite) Full-Time $16.00 - $17.30/Hour Apply Now ... Job Summary: In accordance with the organization's mission, vision and values, the Utilization Management Specialist is responsible for evaluation of the medical… more
- Emanate Health (Covina, CA)
- …and the #19 ranked company in the country. **Job Summary** The Manager Utilization Review/MediCal Specialist will develop and maintain a full Medi-Cal case ... at Emanate Health plays a vital role in the care we deliver. No matter what department you belong...from pre-admission through post-discharge for Medi-Cal patients. The Manager Utilization Review/MediCal Specialist will manage the program… 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 ... clinical and healthcare services, product acquisition and support services...items to include specialized services. Responsibilities As the Acquisition Utilization Specialist you will serve as the… more
- Veterans Affairs, Veterans Health Administration (Shreveport, LA)
- Summary The Supervisory Acquisition Utilization Specialist renders expert contract pre-award and post-award expertise to all Admin and Clinical Service lines ... not a virtual position. Position Description/PD#: Supervisory Acquisition & Utilization Specialist /PD99867S Relocation/Recruitment Incentives: Not Authorized Financial… 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 ... care that may be covered. + Monitors all utilization reports to assure compliance with reporting and turnaround...assure compliance with reporting and turnaround times. + Addresses care issues with the Director of Clinical … more
- Spectrum Billing Solutions (Skokie, IL)
- …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR ... will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for behavioral healthcare services.… more
- Universal Health Services (Groton, CT)
- …DC, Puerto Rico and the United Kingdom. www.uhs.com Job Summary: The Utilization Review Specialist is responsible for the pre-certification, concurrent, and ... (UHS), has an immediate opening for a full-time UR Specialist . Stonington Institute is committed to providing quality substance...to identify and advocate for a particular level of care based on the presenting clinical information.… more
- Henry Ford Health System (Troy, MI)
- …is REMOTE 8 hour shifts between 7:30am and 6:00pm GENERAL SUMMARY: The support specialist is a support role crucial to the centralized Utilization Review team ... and various revenue cycle related requirements. * Submits all clinical information required by payers. * Responds to payer...payers as needed. * Maintain a current knowledge of Utilization Management through interaction with staff and payor portal… more
- FLACRA (Clifton Springs, NY)
- PER DIEM UTILIZATION MANAGEMENT SPECIALIST Finger Lakes Area Counseling & Recovery Agency Clifton Springs, NY (Onsite) Per Diem Apply Now ... the engagement and enrollment of new Client in FLACRA's HHUNY and CHHUNY Care Management Programs. This is done through outreach by performing activities that assist… more
- LA Care Health Plan (Los Angeles, CA)
- Enhanced Care Management Clinical Specialist II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position ... required to achieve that purpose. Job Summary The Enhanced Care Management (ECM) Clinical Specialist ...with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed… more
- Insight Global (Boston, MA)
- …facilities under the provisions of benefits plan. The LTSS Service Authorization Specialist is responsible for applying clinical and benefit administration ... Job Description Clinical Effectiveness (Authorization) Unit is primarily responsible for...Term Services and Supports (LTSS). The LTSS Service Authorization Specialist provides accurate, prompt, and appropriate medical authorizations to… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... defined by the medical staff and the organization; utilizes clinical knowledge and defined standards of care ...maintain the multidisciplinary team approach to ensure effective resource utilization and an appropriate level of care .… more
- HCA Healthcare (San Antonio, TX)
- …and integrity. We care like family! Jump-start your career as a(an) Clinical Pharmacist Specialist Critical Care today with Methodist Hospital. ... vary by location._** Come join our team as a(an) Clinical Pharmacist Specialist Critical Care ....multidisciplinary and bedside rounds + You will complete drug utilization reviews to promote rational drug therapy and implement… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Pharmacy Clinical Specialist position is responsible for performing advanced clinical pharmacy duties enabling the delivery of ... within the designated area(s) of responsibility or populations served. The Pharmacy Clinical Specialist position supports the delivery of pharmacy managed… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Pharmacy Clinical Specialist position is responsible for performing advanced clinical pharmacy duties enabling the delivery of ... within the designated area(s) of responsibility or populations served. The Pharmacy Clinical Specialist position supports the delivery of pharmacy managed… more
- HonorHealth (Scottsdale, AZ)
- …across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Ambulatory Care Clinical Pharmacy Specialist provides expert level ... medication-related outcomes and reduce hospitalizations for at-risk populations. The Ambulatory Care Clinical Pharmacy Specialist will conduct educational… more
- McLaren Health Care (Flint, MI)
- …and/or leadership of subordinate personnel. Assists in the coordination of patient care through the appropriate utilization of all resources: staff, equipment, ... **Department:** Post Anesthesia Care Unit **Shift:** Days **Daily Work Times:** 7:00...Mission , and Values. 2. Demonstrates leadership role through clinical practice, supervision, teaching, and research. 3. Facilitates and… more