- HealthCare Support (Houston, TX)
- Utilization Review RN HealthCare Support is actively seeking a Utilization Review RN to fill an opening with a Prestigious HealthCare Company in Remote ... Houston TX . Daily Responsibilities for Utilization Review RN: WIll need to use their OWN EQUIPMENT: 2 screens, will need a headset, high speed internet,… more
- CoxHealth (Lake Spring, MO)
- …feedback for the following Committees: 1) Coding and Documentation Committee 2) Utilization Review Committee 3)SOI Scorecard Committee 4) Educational sessions ... picture of the patient to include severity of illness, risk and resource utilization through correct MS/APR DRG assignment and CC/MCC captures. Will be responsible… more
- SR International, Inc. (Phoenix, AZ)
- …*Medical nursing practice, medical case management protocols, quality management and utilization review protocols as related to all populations including ... pertaining to the AHCCCS program *Good written and communication skills *Computer skills * Utilization Review skills *Medical Claims Review skills *Producing… more
- Bryan Health (Lincoln, NE)
- …and services; coordinates tours of facility when requested . Performs utilization review activities, including preadmission screening, insurance verification for ... following duties are also required in the department noted above. Performs utilization review activities, including concurrent and retrospective reviews as… more
- Skaggs Community Hospital Association (Branson, MO)
- …meeting numerous requests and deadlines. ▪ Continues education through current review of anesthesia practice (as defined by recertification requirements) and ... and priority setting skills. ▪ Comfortable working knowledge and utilization of Aseptic Technique. ◦ Licensure/Certification/Registration ▪ Required:Missouri State… more
- Aveanna Healthcare (Birmingham, AL)
- …the plan of care and patient needs. Participates in quality improvement, utilization review , and infection control activities as requested. Attends appropriate ... documents such coordination. Collaborates with the interdisciplinary team in the development, review and revision of the clinical component of patient/family plan of… more
- Providence Little Company of Mary Medical Center San Pedro-… (San Pedro, CA)
- …License Certifications: BLS - AHA Must-Have: Strong assessment, discharge planning, and utilization review skills Description: The RN Case Manager coordinates ... timely, efficient, and effective discharge planning and transitions. Supports utilization management and ensures compliance with payer guidelines. Onboarding… more
- CoxHealth (Lake Spring, MO)
- …physician documentation in the medical record through concurrent chart review . Interdisciplinary communication and collaboration with physicians, nursing, and ... team regarding proper clinical documentation utilizing approved guidelines. Understand and utilization of ICD-10-CM and PCS coding assignment and follow Official… more
- Providence Little Company of Mary Medical Center - San Pedro (San Pedro, CA)
- …to perform discharge planning and utilize interqual criteria - Experience in utilization review and concurrent reviews Description: This position requires ... rotating weekend coverage. The candidate will manage a caseload of up to 15 patients on weekdays and a potentially higher number on weekends, depending on census. Responsibilities include care coordination, discharge planning, and ensuring medical necessity… more
- Bryan Health (Kearney, NE)
- …orienting and training family members; providing resources. Actively participates in Utilization Review Committee, QI, varying team meetings and other ... for Medicare, Medicaid, HMO and private insurance coverage. Handle case assignments, review concurrent case progress, and have the ability to adjust plans… more
- Aurora Mental Health & Recovery (Aurora, CO)
- …by telephone for face-to-face evaluation of emergency patients, as appropriate. Provide utilization review of all patients in continuing care to ensure ... appropriate medical/psychiatric services are received, as needed. Attend team and other meetings, as necessary. Provide consultation with staff on patient care and difficult cases, as needed. Understand and comply with organizational goals around quality,… more
- Laurel Pointe Senor Living (Reading, PA)
- …office staff, hospital staff including social workers, discharge planners, utilization review , volunteer coordinators, rehabilitation director, chaplain service, ... pastors, senior services including senior centers, board and care homes, adult day care centers, home health and other community-based referral sources which result in referrals to the community Participate in local organizations, identified as bringing value,… more
- HirefinderRPO (Anchorage, AK)
- …patient progress, problem and plans. Participate in Patient Care Conferences, Utilization Review meetings and Rehabilitation Conferences as needed. Participate ... in in-services training program for other staff in the facility. Record evaluations, daily treatment notes, weekly progress notes, recertification documentation, per Speech and Language Pathologist in the Board State Practice Act and governmental and third… more
- Eisai, Inc (Boston, MA)
- …Executives to work with downstream regional payer accounts of the national payers. Review and analyze applicable data to make informed decisions on regional payer ... operate. Work closely with Medicaid Director and other cross-functional teams to review and analyze applicable data to make informed decisions on individual states… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …their placement in the treatment continuum as well as appropriate utilization and treatment guidelines Proactively leverages detailed knowledge of all applicable ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications A Bachelors Degree required Masters Degree… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …the quality and timely delivery of programming deliverables, including integrated data review plan (IDRP), study data listings and exception reports, sample data ... Reporting staffing needs, prepares annual resource projections, monitors staff utilization , participates in assessment and hiring of candidates.Performs line… more
- Merck & Co. (Rahway, NJ)
- …supply chain deliverables and prepares, analyses, and/or develops mitigation strategies for review with clinical partners and senior leaders. Works directly in the ... Response (IVR) System-development and User Acceptance Testing (UAT) for assigned studies. Utilization of key technological tools and systems for GCS planning such as… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …involves working with suppliers and internal stakeholders to define scope and review of work orders and agreements, Mitigates supplier issues, develops action plans ... intelligence and trends, to help inform Business budgeting and supplier utilization decisions- Partners with senior business stakeholders across functions to… more
- Insmed Incorporated (NJ)
- …A successful candidate will provide knowledge, understanding, interpretation, and utilization of regulatory guidance and regulations from various health authorities, ... of CMC meetings with the regulatory agencies, and draft and review regulatory documents for agency meetings.Provide interpretation of applicable FDA/EMA/ICH/WHO… more
- Yale New Haven Health (East Haven, CT)
- …Of Practice. 14. Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization , And Staff And Self Development As Outlined In Performance ... Review . 15. Performs Other Duties As Assigned Or Directed To Ensure Smooth Operation Of The Asc. Qualifications EDUCATION High School Diploma Or Equivalent required.… more
