- Truman Medical Centers (Kansas City, MO)
- …log 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...requests by Providers. Acts as a department resource for medical service requests /referral management and processes.… more
- FLACRA (Clifton Springs, NY)
- UTILIZATION MANAGEMENT SPECIALIST Finger...and values, the Utilization Management Specialist is responsible for evaluation of the medical ... behavioral health setting. + Valid NYS Drivers' License. + Knowledge of utilization management practices. + Strong interpersonal communication skills. + General… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **Job Summary** The Manager Utilization Review/ MediCal Specialist will develop and maintain a full ... of care from pre-admission through post-discharge for Medi-Cal patients. The Manager Utilization Review/ MediCal Specialist will manage the program to… more
- BayCare Health System (Cotton Plant, AR)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and ... compassionate team. **The Utilization Review Specialist Senior responsibilities include:** +...appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and… more
- Munson Healthcare (Traverse City, MI)
- …of resources. + Assists in developing and revising policies to support utilization management activities, including criteria and guidelines for appropriate use ... colleagues and hospital associates at information meetings. + May represent Utilization Management on various committees, professional organizations, physician… more
- FLACRA (Clifton Springs, NY)
- PER DIEM UTILIZATION MANAGEMENT SPECIALIST Finger Lakes Area Counseling & Recovery Agency Clifton Springs, NY (Onsite) Per Diem Apply Now ... one year of work experience in the behavioral health field with knowledge of utilization management practices. Valid NYS Drivers' License. Get job alerts by… more
- Corewell Health (MI)
- …status. + Utilizes electronic medical record work queues that support Utilization Management functions. + Answers incoming calls or places outbound calls ... to obtain authorization numbers for payment. + Provides clerical support for Utilization Management ; sorting faxes and mail, obtaining authorization numbers,… more
- Trinity Health (Maywood, IL)
- …setting in collaboration with attending physicians. + Actively participates in the Utilization Management committee. **We offer our employees:** + Benefits from ... Loyola campus. Position is hybrid, must reside in Illinois. The Regional Utilization Review Documentation Specialist nurse works with the multidisciplinary team… more
- Amity Foundation (Tucson, AZ)
- …individual is responsible for performing a variety of concurrent and retrospective utilization management -related reviews and functions and for ensuring that ... to teach, learn and join our community as a Utilization Review Specialist at our campus in...determined by the DSM V. + Accurately document the medical necessity and level of care based on evidence-based… 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 ... clinical nursing staff and other departments regarding documentation required for utilization review activities and processes. Collaborate with medical , nursing… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …an interdisciplinary approach to support continuity of care. + Provides utilization management , transfer coordination, discharge planning, and issuance of ... The UR Specialist reviews and monitors patients' utilization ...high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate… more
- Spectrum Billing Solutions (Skokie, IL)
- …cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR Specialist ... Responsibilities include: + Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. +… 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 ... position is to manage the completion of formulary activities, support medication utilization projects, and ensure timely policy management within the department… more
- Hawaii Pacific Health (Honolulu, HI)
- …Services, which provides Hawai'i Pacific Health and its affiliates essential population utilization and financial management support, analyses and modeling. The ... referral management , patient steerage, and claims auditing. As the Specialist , you will be responsible for providing comprehensive managed care information… more
- Veterans Affairs, Veterans Health Administration (Poplar Bluff, MO)
- Summary This position will serve as an Acquisition Utilization Specialist at the John J. Pershing VA Medical Center in Poplar Bluff, Missouri. The incumbent ... is not a virtual position. Position Description/PD#: Acquisition & Utilization Specialist /PD99810S Relocation/Recruitment Incentives: Not Authorized Financial… more
- PeopleReady (CA)
- …usage of agency applications such as Microsoft365, Teams, SharePoint, PowerBI, Case Management and Document Management systems. * Deliver trainings around the ... on processes we are missing in conjunction with the Management staff. * Handle special projects as assigned by...* Accommodations may be requested for a religious or medical exemption from the COVID-19 vaccination requirement. NLACRC Offers… more
- Regis HR Group (Miami, FL)
- …trains and disciplines staff to ensure smooth operations in utilization management . + Also facilitates educational training for medical staff on issues ... Develops, manages and directs the Utilization Management programs for the primary...management solutions. + Creates, manages and updates preferred specialist networks focused on cost-effectiveness and high quality. +… more
- Veterans Affairs, Veterans Health Administration (Vancouver, WA)
- …a small-town charm, this is the place to call home. The VISN 20 Utilization Management Nurse Specialist collaborates with interdisciplinary team members, ... (UM) Programs in VISN 20. The VISN 20 Utilization Management Nurse Specialist works...an administrator, educator, consultant, and mentor to Network and Medical Center leadership/colleagues/staff. Works towards achievement of high quality,… more
- Hackensack Meridian Health (Hackensack, NJ)
- …accurate patient status determinations - OBS vs. Inpatient c. Liaison to the Medical Staff supporting Utilization Management Committee processes d. Hospital ... **Overview** The Senior Utilization Review Physician Specialist collaborates with...to support, and provide assistance and support in overall medical management effectiveness, benchmarked utilization … more