- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient ... approvals from insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use of hospital… more
- Corewell Health (Grosse Pointe, MI)
- …+ Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). + Responsible for managing ... for patients utilizing hospital outpatient, observation or inpatient services. + May review cases for medical necessity, uses InterQual and/or other UR/ UM … more
- Corewell Health (Dearborn, MI)
- …Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2. Responsible for managing ... for patients utilizing hospital outpatient, observation or inpatient services. 4. May review cases for medical necessity, uses InterQual and/or other UR/ UM … more
- Sharp HealthCare (San Diego, CA)
- …roundsReviews every patient under assigned workload initially and reviews based on review of care plan.Makes rounds and sees every patient identified per ... departmental guidelines during hospital stay beginning with the admission review of the case manager and reviews with the Case Manager Lead, as needed.Keeps SRS… more
- Huron Consulting Group (Chicago, IL)
- …established criteria and guidelines. + Maintain accurate and detailed records of review decisions and interactions in the utilization management system. + Generate ... and analyze reports on utilization trends, denials, and appeals to identify areas for improvement. + Ensure compliance with federal, state, and local regulations, as… more