- 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 ensure compliance with utilization management policies. This role conducts admission ...healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence… more
- Spectrum Billing Solutions (Skokie, IL)
- …Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management ... a remote or office/home hybrid position. Your Responsibilities: + Review patient admission and clinical information to... | UR Specialist | Revenue Cycle Utilization Review Specialist | ABA… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …+ Ongoing mentorship, _development,_ and leadership programs + And more **Description** The ** Utilization Review (UR) Specialist ** is a Registered Nurse ... Director of UR. + Performs appropriate and accurate initial, admission (episode day one) and concurrent utilization ...experience or a minimum of two years of previous utilization review experience. + Must have a… 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...and advocating for appropriate levels of care. The UR Specialist works closely with clinical staff, admissions ,… more
- HonorHealth (AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Providence (Missoula, MT)
- …Full time **Job Shift:** Day **Career Track:** Business Professional **Department:** 3500 UTILIZATION REVIEW **Address:** MT Missoula 500 W Broadway **Work ... interdepartmental policies and procedures while adhering to the patient focused admission process. The Quality Management Reviewer demonstrates job related skills in… more
- HonorHealth (AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) responsible for promoting the ... the Utilization Review Nurse and Utilization Review Specialist Nurse job...length of stay (LOS) and reimbursement for all hospital admissions in accordance with set goals and objectives. The… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.Thisis a full-time role. *Purpose of this position: ... *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include supervising staff… more
- Penn State Health (Hershey, PA)
- …an admission to the facility, and for concurrent/continued stay review as appropriate. Also responsible for maintaining compliance with the CMS Conditions ... genetic information._ **Union:** SEIU Healthcare Pennsylvania **Position** RN Registered Nurse Utilization Management Specialist - Utilization Management… more
- HCA Healthcare (Dallas, TX)
- …acute inpatient rehabilitation services prior to returning home. The Clinical Rehabilitation Specialist will review these patients daily until they have strong ... Specialist will assist and coordinate the in-take and pre- admission screening process. The Clinical Rehabilitation Specialist accurately documents… more
- HCA Healthcare (Richmond, VA)
- …acute inpatient rehabilitation services prior to returning home. The Clinical Rehabilitation Specialist will review these patients daily until they have strong ... Specialist will assist and coordinate the in-take and pre- admission screening process. The Clinical Rehabilitation Specialist accurately documents… more
- HCA Healthcare (Largo, FL)
- …and personal growth, we encourage you to apply for our Clinical Rehab Specialist PRN opening. We review all applications. Qualified candidates will be ... have the PRN career opportunities as a(an) Clinical Rehab Specialist PRN you want with your current employer? We...to ensure a responsive and smooth flowing referral and admission process for the inpatient acute rehab program. +… more
- HCA Healthcare (Nashville, TN)
- …for patients in regard to managed care organizations + Conducts utilization review for managed care cases in admissions /intake department + Willingness to ... treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile… more
- Penn Medicine (Lancaster, PA)
- …detailed, involved instructions is essential. + Medication and Allergy Documentation + Review , collect, update, and enter pre- admission medications into the ... day. Are you living your life's work? Job Title: Medication History Specialist Medication Administration Location: 555 N Duke Street Department: Medication History… more
- HCA Healthcare (Kissimmee, FL)
- …personal growth, we encourage you to apply for our Clinical Inpatient Rehab Specialist opening. We promptly review all applications. Highly qualified candidates ... care like family! Jump-start your career as a(an) Clinical Inpatient Rehab Specialist today with HCA Florida Osceola Hospital. **Benefits** HCA Florida Osceola… more
- Hackensack Meridian Health (Neptune City, NJ)
- … admissions and observations as specified by the facility's Utilization Management/ Review Committee for documentation completeness and compliance with ... and serve as a leader of positive change. The **Clinical Documentation Specialist RN** facilitates improvement in the overall quality, completeness and accuracy of… more
- Houston Methodist (Sugar Land, TX)
- …Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management and ... Seven years clinical nursing/patient care experience which includes three years in utilization review , case management or equivalent revenue cycle clinical role… more
- HCA Healthcare (Wichita, KS)
- …and personal growth, we encourage you to apply for our Clinical Rehab Specialist PRN opening. We review all applications. Qualified candidates will be ... **Introduction** Do you have the PRN career opportunities as a(an) Clinical Rehab Specialist PRN you want with your current employer? We have an exciting opportunity… more
- Beth Israel Lahey Health (Burlington, MA)
- …manager. . Assists Utilization Managers with all aspects of utilization review /discharge planning/performance improvement processes. . Functions as liaison ... line with payer expectations, contributing to favorable revenue cycle. The Operational Specialist position will have an impact on provider, patient, and staff… more
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