- Banner Health (Mesa, AZ)
- …pharmacy collaborative practice protocols, to optimize patient regimens and improve clinical outcomes. Ensures utilization of appropriate and cost-effective ... begin making a difference in people's lives. Apply today. This role of Ambulatory Clinical Pharmacist , with Banner Staffing Services is embedded in a primary care… more
- Northwell Health (New York, NY)
- …of experience in care/case management, disease management, population health management, utilization review , quality assurance, or discharge planning (preferably ... onboarding and reassessment, UAS-NY completion, comprehensive assessment, medication review , and post-hospital discharge evaluation. The Clinical Assessment… more
- Veterans Health Administration (Johnson City, TN)
- …care team, or other specialty care. Coordinates with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization ... Collect, scans, and updates health insurance information, promote Veteran registration and utilization of My Healthy Vet (MHV). Train other MSAs on correct clinic… more
- Team Select Home Care (Conshohocken, PA)
- …Practices, Infection Control Plan, EMS Plan, and the Compliance Plan Participates in clinical record/ utilization review of medical records and quality ... will report to the Director of Nursing/Director of Patient Care Services/ Clinical Supervisor /Nursing Supervisor / Clinical Manager.… more
- Housing Services - VOA Mid-States (Louisville, KY)
- …Leadership Development Program VOA University - Staff Development VOA Academy - Clinical Training and Developmen t JOB SUMMARY AND QUALIFICATIONS : Service ... Coordinator will be responsible for ensuring maximum utilization of community resources by residents of Volunteers of...the HUD QA, Administrator will share information with the supervisor for this position as part of the performance… more
- Vensure Employer Services (Humble, TX)
- …in accordance with Agency policies Essential Duties and Responsibilities Assumes clinical and management responsibility for clients assigned to their care. Assists ... home health aides. Assumes responsibility for quality insurance standard relevant to clinical nursing practice for clients under direct care. Assists in the… more
- Veterans Health Administration (Hampton, VA)
- …is located in the Nursing GEC department. The LPN will be providing clinical and medical support for providers within this department. LPN's are responsible for ... and referrals. Completes assignments in a timely manner with constructive utilization of remining time. Initiates, administer, assess, monitor, and report IV… more
- Healthier Mississippi People (Jackson, MS)
- …conditions of patients. To act as liaison between case managers, home health nurses, utilization review , etc. To coordinate patient services and care. To perform ... nursing care and treatment for patients in an assigned clinical area. To coordinate the operations of a ...with UMMC guidelines. Reports patients issues or concerns to supervisor as appropriate. Serves on at least one nursing… more
- CVS Health (Eden Prairie, MN)
- …your understanding of patient safety and error prevention, quality assurance drug utilization review (DUR), pharmacy professional standards such as corresponding ... and being receptive to feedback; actively seeking opportunities to expand clinical and technical knowledge needed to better assist patients Remaining flexible… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services...and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General… more
- Spectrum Billing Solutions (Skokie, IL)
- …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Supervisor to our growing team. The UR ... support to staff in handling escalations and/or issues. + Review patient admission and clinical information to... information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and… more
- Henry Ford Health System (Troy, MI)
- …system-wide improvements and operational processes to ensure optimal and compliant utilization review strategies. Under minimal supervision from the Manager ... GENERAL SUMMARY: The Supervisor of Utilization Management has an...year of experience in project management, revenue cycle, and/or clinical operations. + Minimum of one year of leadership… more
- Actalent (Sunrise, FL)
- …+ Prepare and present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization ... Working under the general supervision of the Director and/or Manager/ Supervisor of Medical Management, and in collaboration with an...or LPN License. + Minimum of one year of utilization review experience and discharge planning in… more
- AmeriHealth Caritas (LA)
- **Responsibilities:** Under the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and ... efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination,… more
- AmeriHealth Caritas (Washington, DC)
- **Role Overview** Under the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and ... to efficiently document and assess patient cases + Strong understanding of utilization review processes, including medical necessity criteria, care coordination,… more
- BJC HealthCare (St. Louis, MO)
- …nurse experience performing care for hospitalized patients. + 2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity ... appropriate and cost-effective use of health care resources. **Responsibilities** + Uses clinical and analytical skills to review and interpret diagnostic test… more
- Commonwealth Care Alliance (Boston, MA)
- … Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical and service authorization review for medical necessity and ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager...direct reports. **Essential Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior… more
- Helio Health Inc. (Syracuse, NY)
- …referring to the medical provider those that require additional expertise. + Review clinical information for concurrent reviews, extending the length of ... degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care… more
- Elara Caring (Fort Wayne, IN)
- …+ Assists staff in maintaining current and accurate medical records and utilization review . + Assists clinical supervisor with non- clinical phone ... the Right Time, in the Right Place. **Job Description:** ** Clinical Coordinator** At Elara Caring, we care where you...you have countless ways to make a difference as Clinical Coordinator. Being a part of something this great,… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical… more
