- Minnesota Department of Natural Resources - Division… (Blackduck, MN)
- …Job Summary The DNR, Division of Forestry is seeking to fill a Forestry Specialist position in Blackduck, MN. Depending on internal movement, this posting may be ... application process, candidates will choose their preferred location(s). The Forestry Specialist position exists to implement program support tasks across all… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ... with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital utilization… more
- FLACRA (Clifton Springs, NY)
- Utilization Management Specialist FLACRA Clifton Springs, NY (Onsite) Full-Time $16.50 - $17.50/Hour Apply Now ... (https://flacra.jobs.net/apply/jqn6gn6t2h294xv9ngh?ipath=CR¬ify=true&siteid=cbnsv) Job Details Job Title: Utilization Management Specialist Location:Finger Lakes Region, NY… more
- Amergis (Wilmington, DE)
- The Utilization Review Specialist is responsible for theassessment and review of the healthcare delivery system with a concentration ontasks that promote ... + A Bachelor's Degree in Nursing or at least two years'experience in Utilization Review preferred + Certification in Utilization Review or UtilizationManagement… more
- Hackensack Meridian Health (Hackensack, NJ)
- **The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... and Hackensack UMC. These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay.… more
- Spectrum Billing Solutions (Skokie, IL)
- …in the most efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist ... software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible ... for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD) treatment at… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- AnMed Health (Anderson, SC)
- …This position is responsible for performing the daily operations of the Utilization Management program at AnMed within the Care Coordination model. These duties ... continued stay/concurrent review, retrospective review, bed status management, resource utilization management, regulatory compliance, and related denial management issues.… more
- TEKsystems (Los Angeles, CA)
- …Vocational Nurse (LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare claims processes. ... + Active LVN or RN license (California) + 2+ years of experience in Utilization Management (UM) + Hands-on experience with HMO/Medicare claims, audits, and denials +… more
- WestCare Foundation (Henderson, NV)
- …or RN and/or Bachelors or Masters level CADC/LADC with 2 years utilization review experience, preferred experience working with individuals with psychiatric or ... substance use disorder Experience and Competencies: + Proven experience in conceptualizing a case and creating a clinical impression to present to all involved and approved parties, including managed care representatives + Knowledge of CPT, ICD 9 & ICD 10… more
- Henry Ford Health System (Troy, MI)
- The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and resolution process. ... Epic preferred. Additional Information + Organization: Corporate Services + Department: Central Utilization Mgt + Shift: Day Job + Union Code: Not Applicable… more
- UnityPoint Health (Cedar Rapids, IA)
- …174223 Overview This position is on site at St. Luke's Hospital. The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments ... care, optimal clinical outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management function for patients admitted to… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... necessity of outpatient observation and inpatient stays and the utilization of ancillary services + Perform other duties as...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years in Case… more
- American Management Group, LLC (AMG) (Los Angeles, CA)
- …procurement of goods and services to support healthcare operations. The Acquisition Utilization Specialist serves as the primary liaison between program offices, ... Acquisition Specialist Los Angeles, CA Apply Now Acquisition Specialist Work Location: VA Greater Los Angeles Healthcare System-11301 Wilshire Blvd, Los Angeles,… more
- Community Health Systems (Franklin, TN)
- …secure timely authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist . + Monitors and updates case ... **Job Summary** The Utilization Review Coordinator ensures efficient and effective management... Review Coordinator ensures efficient and effective management of utilization review processes, including denials and appeals activities. This… more
- Penn State Health (Hershey, PA)
- …(MAILTO://###@pennstatehealth.psu.edu) **SUMMARY OF POSITION:** Under the direction of a Utilization Management Nurse or Specialist , the Utilization ... or outlaw discrimination._ **Union:** Non Bargained **Position** UM Coordinator - Utilization Management **Location** US:PA: Hershey | Clerical and Administrative |… more
- St. Luke's University Health Network (Sellersville, PA)
- …partners with participants to facilitate their recovery and community integration through utilization of the Specialist 's personal life experience and first-hand ... ability to pay for health care. The Certified Peer Specialist (CPS) has the lived experience of a mental...educational courses and self-help groups. + Identify and promote utilization of natural community resources that support peers' goals… more
- Henry Ford Health System (Rochester Hills, MI)
- …of pharmacy services, decrease waste, and rework in the region, and improve drug utilization . The Pharmacy Specialist will be instrumental in guiding the further ... join Henry Ford Health as a Full Time Pharmacy Specialist and make an impact on our Pharmacy Advantage...provided by the primary care team. He/she works with utilization management reports, corporate data stores, and information services… more
