- Kelsey-Seybold Clinic (Pearland, TX)
- **Responsibilities** The Utilization Management Representative (UMR) provides office support for all units within the Utilization Management and/or ... include direct communication with KSC Clinic Representatives as needed. The Utilization Management Representative is responsible for clerical… more
- Elevance Health (Denver, CO)
- ** Utilization Management Representative II** **Location: Colorado Springs, CO** The ** Utilization Management Representative II** is responsible ... benefits and/or eligibility information. + May act as liaison between Medical Management and internal departments. Responds to telephone and written inquiries from… more
- Universal Health Services (Chicago, IL)
- …continued treatment based on payer's criteria and in accordance with the hospital wide Utilization Management Plan. Serves as liaison to 3rd and 4th party ... physician reviews with payers as required. Maintains all records/data pertaining to the Utilization Management Program. Actively participates in Utilization … more
- Universal Health Services (Memphis, TN)
- Responsibilities Utilization Management Coordinator Compass Intervention Center is seeking a dynamic and talented Utilization Management Coordinator. Our ... in service delivery. Visit our website at www.compassinterventioncenter.com. The Utilization Management Coordinator will possesses knowledge of psychiatric… more
- Universal Health Services (Chicago, IL)
- …JOB SUMMARY: Responsible for all denial and appeal activities for the Utilization Management department, including Expedited Appeals, Standard Appeals, External ... to resolve issues related to appeals. Maintains all records/data pertaining to the Utilization Management Program. Actively participates in Utilization … more
- Colorado State University (Fort Collins, CO)
- …partners and cooperators. The Program Specialist will also serve as a CSFS representative and advocate for forest management and social change consistent with ... resources will be considered. + Four years of combined forest products utilization experience and forest or natural resource management program administration… more
- Universal Health Services (Riverside, CA)
- …collection of accurate data from utilization of services within the Utilization management Department. Prepare useful utilization statistics from this ... and implement monthly utilization statistics, as necessary, for use in Utilization Management Department and Utilization Management Committee.… more
- Universal Health Services (Chicago, IL)
- …based on payer's criteria and in accordance with the hospital wide Utilization Management Plan. Coordinates with the Business Office, Admissions Department ... and Utilization Management Department. Obtains billing and insurance...each primary duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Education:… more
- Elevance Health (Miami, FL)
- …of Florida. + Requires minimum of 5 years acute care clinical experience, utilization management or managed care experience; or any combination of education ... Senior RN Utilization Review/ Management (Acute InPatient) JR116937 **Location:**...to other areas of the business unit or as representative on enterprise initiatives. + Assigns and audits daily… more
- Universal Health Services (Auburn Hills, MI)
- Responsibilities Utilization Management - Precertification Specialist HAVENWYCK HOSPITAL (a UHS facility) Havenwyck Hospital sa Joint Commission-accredited and ... information, please visit us at www.havenwyckhospital.com POSITION SUMMARY: The Utilization Management Precertification Specialist has responsibility for… more
- UNC Health Care (Hendersonville, NC)
- …management referrals. Initiates appropriate social work referrals. * Performs utilization management assessments and interventions, using collaboration with ... health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review cases… more
- State of Indiana (Indianapolis, IN)
- …Nurse (RN) in the State of Indiana. * Two years prior experience with utilization management . * Demonstrated competence in quality assurance and case ... Utilization Review Coordinator Date Posted: May 31, 2024...accessible, and equitable workplace with a workforce that is representative of Indiana's population. As a proud equal opportunity… more
- Dignity Health (Northridge, CA)
- …400 care centers. Visit dignityhealth.org/northridgehospital for more information. The RN Utilization Management Coordinator (UMC) is responsible for assessing ... other relevant health team members, the patient or patient representative and post acute care providers in accordance with...+ Current CA Registered Nurse (RN) license + Prior Utilization Management experience in a clinical or… more
- Catholic Health (Lockport, NY)
- … Review/ Transitions of Care, as an active member of the Care Management and interdisciplinary care team, provides comprehensive Utilization Review and ... barriers for delays of treatment. The RN Care Manager engages the patient/patient representative in developing and implementing a post hospital plan that best meets… more
- Office of the Secretary (Washington, DC)
- …to the Secretary of Veterans Affairs on small and disadvantaged business utilization . The incumbent is the Department's chief small business and Veteran ... entrepreneurial advocate, ombudsman, and representative on all small business and Veteran entrepreneurial issues within VA. Responsibilities The responsibilities… more
- Hawaii Pacific Health (Honolulu, HI)
- …Services, which provides Hawai'i Pacific Health and its affiliates essential population utilization and financial management support, analyses and modeling. The ... services in collaboration with the managed care services department including referral management , patient steerage, and claims auditing. As the Specialist, you will… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …makes recommendations, and refers potential denials to the Medical Directors and Management when necessary to ensure compliance with URAC standards, MNRO and DOL ... meeting targets for staff and unit performance as required by company and management standards. Assists supervisor and other units of Care Management maintaining… more
- Houston Methodist (Nassau Bay, TX)
- At Houston Methodist, the Case Management Representative position is responsible for providing clerical assistance and data management support to the case ... management and social work department to facilitate efficient utilization of resources and discharge planning including referrals management , communication… more
- UT Health (Houston, TX)
- Employee Assistance Programs (EAP) Account Representative in Human Resources **Location:** Texas Medical Center-Houston, Texas **Hot** **Category:** Clinical ... Summary:** UTHealth Houston is looking for an Employee Assistance Programs Account Representative with a strong mental health assessment, counseling, and crisis … more
- Sharp HealthCare (San Diego, CA)
- …and in writing. + Function well in demanding/stressful environments. + Basic utilization management . Sharp HealthCare is an equal opportunity/affirmative action ... **FTE** 0 **Shift Start Time** **Shift End Time** Certified Revenue Cycle Representative (CRCR) - HFMA; HS Diploma or Equivalent **Hours** **:** **Shift Start… more