- Sheppard Pratt (Amesbury, MA)
- General Summary Under general supervision, provides day-to-day leadership of the utilization review process of patients admitted to the Hospital for Inpatient ... of care. Trains or ensures the proper training of newly hired Utilization Review Coordinators, coordinates work assignments, and provides effective liaison… more
- Ascension (Baltimore, MD)
- …health care services regarding admissions, case management, discharge planning and utilization review . Responsibilities: Review admissions and service ... planning needs with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversee and coordinate compliance to… more
- Riverside County, CA (Moreno Valley, CA)
- …Health System-Medical Center is seeking an Assistant Director of Case Management and Utilization Review to join our UR Case Management Department located in ... an accredited acute care hospital. Professional experience in case management and utilization review in a hospital is preferred. Schedule: 9/80 after 90 days… more
- Zenex Partners (Beverly Hills, CA)
- Description Job Opportunity: LVN / LPN - Utilization Review Facility: CSMN - 1101017 Nursing Clinical Support Location: Beverly Hills, CA Employment Type: ... Travel/Contract Shift: Day (5x8 Hours) 8:00 17:00 Start Date: 2/17/2025 Job Duration: 13 weeks Compensation: Rate Type: Hourly Over Time: Default Multiplier: None; 8 Hour Multiplier: 40 total hours in 1 week: 1.3%; 10 Hour Multiplier: 40 total hours in 1 week:… more
- Pharmacy Careers (Gilbert, AZ)
- Formulary Strategy & Utilization Review Pharmacist Shape the drug benefit landscape-analyze and optimize medication use. Key Responsibilities: Review ... prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple payers. Conduct retrospective DUR and prepare stakeholder reports. Qualifications: PharmD with managed care, DUR, or pharmacy benefit experience.… more
- Baton Rouge General (Baton Rouge, LA)
- …team that shapes the future of patient care through resourceful and compassionate utilization review ? What We're Looking For: Strong leadership and advocacy ... record of team support and development Minimum 3 years of hospital utilization review experience preferred At least 1 year of supervisory experience preferred… more
- Singing River Health System (Ocean Springs, MS)
- Utilization Review Surgery Nurse - RN Ocean Springs Hospital | Full-Time | Monday-Friday rotating weekends/Holidays | 3109 Bienville Blvd Ocean Springs, ... and/or transfer. Prefer ACM or CCM (Certified Case Manager), Certification in Utilization Review , Certified Professional in Healthcare Quality-CPHQ is a plus.… more
- American Traveler (Boston, MA)
- …include managing acute care cases and collaborating with interdisciplinary teams, *Must provide two professional references for consideration, *Parking at Boston ... American Traveler is seeking an experienced RN Case Manager with acute case management experience and an active MA RN license. Job Details *Position is based in a hospital setting within the case management department, *Day shift schedule from 08:00 to 16:30,… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- … review , and transitions to prevent readmissions. Liaise with medical staff, utilization review , social services, payors, and community providers. Track and ... rounds. Manage department budget, staffing, and training needs. Function as Utilization Review /Denials Manager as required. Qualifications Registered Nurse (RN)… more
- Kaiser Permanente (Panorama City, CA)
- …the general and specialized principles, practices, techniques and methods of Utilization review /management, discharge planning or case management. Working ... during case review or other activities. Reviews, analyses and identifies utilization patterns and trends, problems or inappropriate utilization of resources… more
- Kaiser Permanente (Aurora, CO)
- …requests, including discharge planning activities when needed (collective referred to as Utilization Review ) for the Colorado region. Manages utilization ... concurrent requests. Responsible for the planning and decision-making related to utilization review . Develops and implements departmental policies and… more
- Ascension (Baltimore, MD)
- …Manage activities, workflow and resources of assigned nursing travelers. Ensure compliance with regulatory and accreditation requirements for their assigned team. ... Identify and resolve issues affecting the delivery of patient care services for the assigned team. Develop and implement policies and procedures to guarantee efficient and effective delivery of health services. Monitor and adhere to budget. Approve and monitor… more
- Central Health (Austin, TX)
- …as may be required by Central Health or facility in the performance of utilization review cases. Complies with the established timeliness standards for referral ... flexibly within a dynamic work environment. Proficiency in understanding the utilization review process, healthcare policies, and compliance regulations.… more
- Talent Software Services (Santa Barbara, CA)
- …Required: CA RN License Job Duties: The role involves coordinating utilization management, resource management, discharge planning, post-acute care referrals, and ... Department. Promoting patient wellness and improved care outcomes. Ensuring efficient utilization of health services. Minimizing denials of payment among a patient… more
- NYC Health Hospitals (New York, NY)
- …conduct the orientation of new employees. 5. Supervision of staff of the Utilization Management Department. 6. Determine, outline, and review daily assignments ... Utilization Management Department. 7. Plan, prepare, manage, review , and approve the Time and Leave Schedule, including...other Leaves of Absence, for all staff of the Utilization Management Department. 8. Review , edit, correct,… more
- Strategic Staffing Solutions (Detroit, MI)
- …which may include acute patient care, discharge planning, case management, and utilization review , etc. Demonstrated clinical knowledge and experience relative ... Strategic Staffing Solutions is currently looking for an RN Review Analyst for a contract opportunity with one of...our largest clients located in Detroit, MI! Title: RN Review Analyst Location: Detroit, MI (Mostly remote; may be… more
- Novo Nordisk Inc. (Hackensack, NJ)
- …appropriate patients that would benefit in order to ensure early trial and utilization Generate advocacy for Novo Nordisk products and services by sharing approved ... and marketing resources to expand the breadth and depth of appropriate utilization Novo Nordisks products, consistent with label and company policy Maintain mastery… more
- Iconma LLC (Detroit, MI)
- …which may include acute patient care, discharge planning, case management, and utilization review , etc. Demonstrated clinical knowledge and experience relative ... Client, a Health Insurance company, is looking for a Registered Nurse- Review Analys for their Detroit, MI/Hybrid location. Responsibilities: Perform prospective,… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …and people resources, supporting appropriate use of NNI products and greater utilization of its services Takes a leadership role in coordinating activities at ... health care providers Support appropriate use of NNI products and greater utilization of its services Support representatives in answering physicians questions Works… more
- Novo Nordisk Inc. (Seattle, WA)
- …appropriate patients that would benefit in order to ensure early trial and utilization Generates advocacy for Novo Nordisk products and services by sharing approved ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications Bachelor's or equivalent degree, and/or Pharm… more
