- Novo Nordisk Inc. (Tacoma, WA)
- …obesity to maximize sales within an assigned territory. The Obesity Care Specialist (OCS) must achieve sales goals by implementing marketing and sales strategies ... assess, create and maintain advocacy of customers aligned to company, brand and clinical goals. The OCS develops local strategies and executes local tactical plans… more
- University of Colorado (Aurora, CO)
- Clinical Utilization Review Specialist - 32339 University Staff **Description** **University of Colorado Anschutz Medical Campus** **School of Medicine | ... Department of Psychiatry** **Job Title: Clinical Utilization Review Specialist ** **Position: #00217340 - Requisition: #32339** **Sign-on bonus available… more
- Montrose Memorial Hospital (Montrose, CO)
- …provided. This position combines the unique skill sets of the Utilization Review Nurse and Clinical Documentation Specialist to facilitate documentation ... patient. About The Career: + The purpose of the Clinical Revenue Specialist position is to ensure...experience preferred; and one (1) to two (2) years Utilization Review experience preferred. What We Offer:… more
- Munson Healthcare (Traverse City, MI)
- …families, interdisciplinary team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic ... Nurse in the State of Michigan. + Minimum of three years clinical experience required. Previous utilization review and/or case management in a hospital or… more
- BayCare Health System (Cotton Plant, AR)
- …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… more
- Sutter Health (Berkeley, CA)
- …and others to ensure appropriate utilization and quality care through utilization review , tracking and evaluation and objectively compare criteria with ... nursing staff and other departments regarding documentation required for utilization review activities and processes. Collaborate with medical, nursing… 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... information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and… more
- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …leadership, teamwork, and communication skills. ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical ... of candidates. Education Associates Degree preferred Minimum Work Experience Utilization Review experience preferably in a behavioral/psychiatric healthcare… more
- Universal Health Services (Groton, CT)
- …Washington, DC, Puerto Rico and the United Kingdom. www.uhs.com Job Summary: The Utilization Review Specialist is responsible for the pre-certification, ... (UHS), has an immediate opening for a full-time UR Specialist . Stonington Institute is committed to providing quality substance...or related Human Service Field or RN. Knowledge of Utilization Review Processes, insurance plans, mental health… more
- Providence (Portland, OR)
- …the best people, we must empower them._** **Providence Health Plan is calling an Associate Utilization Review Specialist who will:** + Be responsible for all ... core functions in one or more of the following clinical teams: + Prior-authorization (PA) + Concurrent Review (CCR) + SNF + Clinical Claims + Provider… 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...times. + Addresses care issues with the Director of Clinical Services and Chief Medical Officer/Medical Director as appropriate.… more
- Truman Medical Centers (Kansas City, MO)
- …into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Specialist 101 Truman Medical Center **Job ... training, coaching and consulting to outside organizations. **Job Description** The Utilization Specialist will verify all financial and insurance information,… 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 ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will...setting. Performs telephonic and/or on site admission and concurrent review , and collaborates with on site staff, physicians, providers,… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management/Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... Job Summary The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provides direct assistance to member's with health… more
- Sanford Health (SD)
- …level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to assure ... relating to determination of medical necessity, authorization, continued stay review including diagnosis and procedural coding for working diagnosis related… more
- University of Virginia (Charlottesville, VA)
- As a Medication Utilization , Formulary, and Policy Specialist , you will play a crucial role in optimizing medication management practices UVA. The primary focus ... position is to manage the completion of formulary activities, support medication utilization projects, and ensure timely policy management within the department of… more
- Ascension Health (Indianapolis, IN)
- …process. + Serve as content specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation. + ... with your Talent Advisor for additional specifics._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing… more
- Corewell Health (Grand Rapids, MI)
- …a variety of services including developing and implementing evidence-based clinical programs and quality-oriented drug management services, instituting practices to ... in the managed care setting. Essential Functions + Performs day to day clinical pharmacy functions including prior authorization and appeal reviews. + Uses … more
- Alameda Health System (San Leandro, CA)
- … utilization and an appropriate level of care. 5. Coordinates all utilization review functions, including response to payor requests for concurrent and ... continued stay using evidence from the medical record and clinical review tools, as well as input...of Case Management experience in an acute setting or utilization review at a medical group or… more
- LA Care Health Plan (Los Angeles, CA)
- Enhanced Care Management Clinical Specialist II (RN or LCSW) 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 II is responsible for the management and oversight… more
