- Trinity Health (Des Moines, IA)
- …colleagues and a medical staff of almost 1,500 physicians and allied health professionals, MercyOne Central Iowa is one of Iowa's largest employers. Want to ... Case Management staff utilizing admission criteria guidelines-and second level physician review process when appropriate. Interacts with insurance providers to… more
- New York State Civil Service (Buffalo, NY)
- NY HELP Yes Agency Mental Health , Office of Title Utilization Review Coordinator, (NY HELPS), Greater Binghamton Health Center, P26033 Occupational Category ... you may be terminated from your employment. Minimum Qualifications Greater Binghamton Health Center is recruiting for a Utilization Review Coordinator to… more
- Medical Mutual of Ohio (OH)
- Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 ... stay and level of care. + Extrapolates and summarizes medical information for physician review or other...combination of clinical and utilization/case management experience in the health insurance industry. + Experience in clinical… more
- Corewell Health (Royal Oak, MI)
- …Board review and processing. Qualifications Required + Master's degree in clinical health science, such as nursing, medical technology, etc. or a related ... Job Summary The Internal Review Board Specialist coordinates processes related to the...or government agency or a bachelor's degree in a health related field with a minimum of 5 years… more
- Centene Corporation (San Antonio, TX)
- …per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance , 401K and stock purchase plans, tuition reimbursement, paid ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a...and/or Compact State Licensure.** **Position Purpose:** Performs a clinical review and assesses care related to mental health… more
- Logan Health (Kalispell, MT)
- …Include: + Competitive Compensation + Comprehensive Health Benefits - Including medical , dental, and vision insurance + Retirement Plan with Employer Match ... Health as an RN Analyst - Physician Peer Review ! Our Mission: Quality, compassionate care for all. Our...needed, candidates must reside within 30 miles of Logan Health Medical Center. + Scenic Setting: Nestled… more
- Centene Corporation (Carson City, NV)
- …per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance , 401K and stock purchase plans, tuition reimbursement, paid ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a...perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health… more
- BAYADA Home Health Care (Orlando, FL)
- …following: Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance , 401k with company match, direct ... Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding ...Review Manager provides support to all BAYADA Home Health Care Medicare service offices by monitoring Outcome and… more
- Trinity Health (Fort Lauderdale, FL)
- …Review Department. Interfaces with all payors/providers requesting authorizations, medical records, and other specific information. Confirms completeness of ... operation functions, as it relates administrative/clerical support for Utilization Review .** Under the direction of the Care Coordination Department Leadership,… more
- BAYADA Home Health Care (Orlando, FL)
- …following: Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance , 401k with company match, direct ... industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding, Coder, Medicare **As… more
- Catholic Health Initiatives (Omaha, NE)
- …patients. **This position offers the flexibility to work remotely with proven Utilization Review experience.** Medical Coding experience is a plus! As our ... payer-defined criteria. + Facilitate Peer-to-Peer reviews between hospital providers and insurance providers, when necessary. + Communicate review outcomes and… more
- Alameda Health System (Oakland, CA)
- …outpatient). 3. Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may not meet medical necessity criteria. ... of current trends and changes in healthcare delivery as it pertains to utilization review (eg, medical necessity, level of care) by participating in appropriate… more
- Beth Israel Lahey Health (Burlington, MA)
- …Manager experience as well as Utilization Review experience ( review medical necessity and discharge planning) **As a health care organization, we have ... making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center in Burlington… more
- Trinity Health (Mason City, IA)
- …Full time **Shift:** Day Shift **Description:** **JOB SUMMARY:** The Utilization Review Case Manager responsibilities include case screening, insurance approval, ... employer match starting on Day 1 **Ministry/Facility Information:** **MercyOne North Iowa** Medical Center provides expert health care to 15 counties. MercyOne… more
- Conduent (Charlotte, NC)
- …and be part of a culture where individuality is noticed and valued every day. ** Medical Review Auditor Analyst (Remote - Charlotte Area)** **Are you a strong, ... please apply!** **Job Summary:** Conduent is seeking an experienced Medical Review Auditor Analyst to join our...or incentives. Conduent offers a variety of benefits including health insurance , dental and vision programs, life… more
- RWJBarnabas Health (Oceanport, NJ)
- …physical, emotional, social, and financial health . + Paid Time Off (PTO) + Medical and Prescription Drug Insurance + Dental and Vision Insurance + ... Quality Review Representative, Patient Accounts Training & EdReq #:0000191234...& Long Term Disability + Life & Accidental Death Insurance + Tuition Reimbursement + Health Care/Dependent… more
- Covenant Health (Lewiston, ME)
- …Covenant Health Ministry. + Conducts admission, continued stay, and retrospective medical necessity review using health system-approved criteria. + ... Summary The UR Case Manager conducts medical necessity reviews per the Utilization Management (UM)...the patient and assists in providing information regarding their insurance coverage. Essential Duties and Responsibilities + Supports and… more
- Ascension Health (Baltimore, MD)
- …$103,242.70 - 139,681.30 per year **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer ... processes, including management of patient statusing processes and monitoring of medical necessity review functions for assigned sites. + Collaborate with… more
- Conduent (Baton Rouge, LA)
- …incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and ... individuality is noticed and valued every day. As a Medical Benefit Review Services Associate, Region 3,...Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision… more
- CRC Insurance Services, Inc. (Bridgeport, CT)
- …preferred, along with a minimum of three (3) years' experience in a related insurance /employee medical benefits sales role. + In-depth knowledge of group ... **Work Shift:** 1st Shift (United States of America) **Please review the following job description:** As part of our...benefits may be determined by the division of TIH Insurance offering the position. TIH offers medical ,… more