- Novo Nordisk Inc. (Plainsboro, NJ)
- About the Department The Clinical, Medical and Regulatory (CMR) department at Novo Nordisk is one of the most diverse and collaborative groups within the ... and implementing regulatory strategies with the FDA to providing medical education and collecting data to support efficacy and...ready to make a difference? The Position The Assoc Director OED - Supplies, is responsible for US and… more
- RestoraCare Staffing (Houston, TX)
- …continuous improvement in both areas. Refers cases and issues to Care Management Medical Director in compliance with department procedures and follows up as ... Clinic (FQHC), skilled nursing facility, or wound clinic). Experience in utilization management, case management, discharge planning or other cost/quality management… more
- Marwood Nursing and Rehab (Port Huron, MI)
- …Responsible for the total nursing care of residents as directed by the Medical Director , attending physician, Director of Nursing and designated ... Rehabilitation*Daily Work Times:* 7:00pm - 7:30a*Scheduled Bi-Weekly Hours:* 72*Outstanding benefits: Medical , Dental, Vision and More*Caring for you begins in the… more
- Trinity Health (Boise, ID)
- …Saint Alphonsus is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This position will be ... annually by the Saint Alphonsus Chief Clinical Officer. The Medical Director of Documentation and Utilization Excellence (MDDUE) is the lead provider for… more
- Universal Health Services (Bradenton, FL)
- Responsibilities Palm Shores Behavioral Health is currently seeking a Director of Admissions and Utilization Management Palm Shores Behavioral Health Center ... a proud provider of the Patriot Support Program. The Director of Admissions/ Utilization Management is responsible for...Physicians and the Clinical Department to ensure quality of documentation of patient care. This position is responsible for… more
- Universal Health Services (Sacramento, CA)
- Responsibilities Sierra Vista Hospital is seeking a talented and dynamic Director of Utilization Management to join our team of dedicated healthcare ... alcohol detox and outpatient chemical dependency services. Position Summary: The Clinical Director of Utilization Management is responsible for the development… more
- Albany Medical Center (Albany, NY)
- …to achieve continuous improvement in both areas. + Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures and ... documents findings based on Departmental standards. + While performing utilization review identifies areas for clinical documentation ...ancillary staff. Thank you for your interest in Albany Medical Center! Albany Medical is an equal… more
- Billings Clinic (Billings, MT)
- …payer UM representatives on denials and coordinate peer to peer review with payer's medical director *Initiates and coordinates peer to peer reviews on all ... or level of care. *Obtains information not documented in the EMR and requests documentation of medical necessity to support appropriate status (IP, OP, OBS) and… more
- Albany Medical Center (Albany, NY)
- …actions to achieve continuous improvement in both areas.* Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures and ... and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation ...care team Thank you for your interest in Albany Medical Center! Albany Medical is an equal… more
- University of Utah Health (Salt Lake City, UT)
- …clinical review. + Reviews patient chart to ensure patient continues to meet medical necessity. + Documentation of all actions and information shared with ... organization through the provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such care; achieved via managing… more
- Universal Health Services (Colorado Springs, CO)
- … Management Care Coordinator opportunity available, this position reports to the Director of Utilization Management. Schedules vary. About the Position: This ... position is responsible for providing initial, ongoing, and systematic utilization review on all patients assigned by Director , coordinating patient care;… more
- AdventHealth (Altamonte Springs, FL)
- …which have been referred to the physician for peer-to-peer review with the Medical Director of the insurance carrier. **The expertise and experiences you'll ... **The role you'll contribute:** . The role of the Utilization Management (UM) Registered Nurse (RN) is to use...patients and their families; . Completion of all required documentation in the Cortex platform and in the system's… more
- Guthrie (Sayre, PA)
- …as necessary with the hospital Business Office, physician offices, Care Coordination, Medical Director and other hospital departments as appropriate. a) Serves ... coding, medical record or chart auditing, and experience in utilization management processes preferred. Knowledge of computer applications (such as Microsoft… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN (Outpatient) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations of… more
- St. Luke's University Health Network (Bethlehem, PA)
- … and participate in performance improvement activities. + Provide support to Network Director Utilization Review, Utilization Review Nurses and the ... we serve, regardless of a patient's ability to pay for health care. The Utilization Review Assistant is responsible for taking the data provided to their department… more
- University of Colorado (Aurora, CO)
- …Skills, and Abilities:** + Well-developed knowledge and skills in areas of utilization management, medical necessity, and patient status determination. + Ability ... recruitment advertising agency (https://www.jobelephant.com/) The University of Colorado Anschutz Medical Campus is seeking a Medicaid Utilization Review… more
- Dignity Health (Rancho Cordova, CA)
- …review a referral. Fosters the relationship between the Pre-Authorization team and the Medical Director and Physician Reviewers. - Tracks cost savings from ... home.** **Position Summary:** Under the guidance and supervision of the department Manager/ Director , the Supervisor of Utilization Management is responsible and… more
- AdventHealth (Maitland, FL)
- …Site position** **The role you'll contribute:** As the physician advisor, the Executive Medical Director of Revenue Cycle educates, informs, and advises members ... related to denial prevention measures for our contracted managed care payers. The Medical Director is responsible for providing physician review of … more
- Martin's Point Health Care (Portland, ME)
- …prior authorization requests (prior authorization, concurrent review, and retrospective review) for medical necessity referring to Medical Director as needed ... "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a...for ensuring the receipt of high quality, cost efficient medical outcomes for those enrollees with a need for… more
- Ascension Health (Indianapolis, IN)
- …and implement quality review programs and key performance indicators for all utilization review activities. + Interact with medical , nursing, and executive ... **Details** + **Department:** Utilization Management + **Schedule:** Full time, Mon-Fri 8am-5pm...including management of patient statusing processes and monitoring of medical necessity review functions for assigned sites. + Collaborate… more
