- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for receiving/reviewing… more
- Cedars-Sinai (Los Angeles, CA)
- …Assists with investigation and follow-up regarding customer complaints. + Serves as liaison with other units in the Admissions department. **Qualifications** ... of service cash collections and cash flow, and provide efficient and appropriate utilization of resources. Acts as a resource for team members by assisting with… more
- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500016 Admissions Center-SMH Work Shift: UR - Rotating (United States of America) Range: ... **Responsibilities:** GENERAL SUMMARY Coordinates or manages inpatient and outpatient admissions , including bed assignments and the completion of preliminary… more
- Cedars-Sinai (Los Angeles, CA)
- …Assists with investigation and follow-up regarding customer complaints. + Serves as liaison with other units in the Admissions department. **Qualifications** ... of service cash collections and cash flow, and provide efficient and appropriate utilization of resources. Acts as a resource for team members by assisting with… more
- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500016 Admissions Center-SMH Work Shift: UR - Rotating (United States of America) Range: ... financial eligibility, secures account for billing and coordinates account management through discharge Completes appropriate forms to complete Death Certificate… more
- Calvary Hospital (Bronx, NY)
- …pertinent data. 8. Knowledge of and experience in Quality Assessment and Improvement, Utilization Review. 9. Ability to develop management systems to track data ... Outreach, Admitting and Intake implementing changes when appropriate. Acts as liaison between Calvary Hospital and referring institutions and providers. Actively… more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior Registered ... Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually...doctor to coordinate and screen for the appropriateness of admissions and continued stays. They make recommendations to the… more
- UTMB Health (Webster, TX)
- …efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions, ... UTMB TDCJ Hospital to specialty services hospitals. **_ESSENTIAL JOB FUNCTIONS_** **:** Utilization Management + Demonstrates thorough knowledge of Inter Qual… more
- Community Health Systems (Franklin, TN)
- …preferred **Knowledge, Skills and Abilities** + Strong knowledge of utilization management principles, payer requirements, and healthcare regulations. ... Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and appeals… more
- CaroMont Health (Gastonia, NC)
- …to MCO via fax, Provider Link, or telephonically. Gathers and disseminates Utilization Management information to medical staff departments, Nursing departments, ... to practice in NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management , Quality and/or Case Management preferred.… more
- Wellpath (Lemoyne, PA)
- … utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and stakeholders, and ... **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization...to reduce length of inpatient stays and decrease ED admissions . + Evaluate and recommend policy improvement related to… 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 ... of services and appropriate service reimbursement. Monitors and acts as a liaison between external payers, internal business office, admissions staff, and… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …management committee, in defining operational strategic objectives for the Utilization Management Program and serves as the liaison to other medical staff ... * Act as physician liaison between case management / utilization management and providers to...* Review and report on PEPPER metrics; (LOS, CMI, Re- admissions , OBS rates, and governmental audit measures) to Hospital… more
- Ventura County (Ventura, CA)
- …medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality Assurance Staff. + Participates, as ... surgical procedures, referrals, tests, medication approvals requiring authorization.) + Develops utilization management standards and guidelines for approval by… more
- Mount Sinai Health System (New York, NY)
- …limited to: a. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using ... **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case Manager (CM) will...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
- Logan Health (Kalispell, MT)
- Logan Health Wellness & Pain Management is proud to offer some of the most comprehensive pain and wellness care in the United States. Job Description Summary Logan ... Health Wellness and Pain Management is looking for an LCSW, LCPC or LMFT...Duties: + Triages referrals from providers and ensures on-going liaison occurs with stakeholders as applicable to assigned area(s).… more
- Houston Methodist (Sugar Land, TX)
- …with clinical team partners. This position uses sound clinical judgement in the Utilization Management process and knowledge of regulatory requirements to make ... Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management and… more
- Community Health Systems (Carlsbad, NM)
- …+ Refers cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ensures appropriate follow-up. + Identifies avoidable ... laws and Joint Commission standards. + Acts as a liaison to community agencies, providing resources and services for...experience required + 3-5 years of experience in care management or utilization review required + 1-3… more
- HCA Healthcare (Gainesville, FL)
- …to decisions regarding ER and interfacility transfer patients. + Serves as first line liaison for problem solving for Bed Management . + Actively functions as ... an on-going focus on quality and efficiency. + Screens admissions for appropriateness of level of care and bed...the patient flow program effectiveness as it relates to utilization review, resource management , and discharge planning… more
- University of Southern California (Arcadia, CA)
- …timely and accurate information to payers. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... follows up to resolve problems with payers as needed. + Completes utilization management for assigned patients. + Coordinates/facilitates patient cares… more