- Freeman Health System (Joplin, MO)
- …healthcare solutions. Schedule: Part-Time 30 hours per week What You'll Do The Utilization Review Coordinator provides utilization review to ... assure patients are admitted to the hospital in the correct status according to applied criteria. They work closely with payers to assure correct authorization for admissions are given and if needed to appeal payer decisions. They also assure the system is… more
- Kaiser Permanente (Sacramento, CA)
- …Experience Minimum three (3) years of home care nursing experience or quality utilization review experience. Education Bachelors degree in nursing or related ... Job Summary: Coordinates quality, utilization and risk management activities for the Home...of important aspects of patient care through ongoing chart review with pre-established criteria. Reports all occurrences which may… more
- UnitedHealth Group (Puyallup, WA)
- …the link between patients and the appropriate health care personnel, the Clinical Review Coordinator - Onsite is responsible for ensuring efficient, smooth, and ... with the company's technical vision and strategy. The Care Coordinator - Onsite plays an integral role in optimizing patients'...to CMS criteria When H&C Transitions is delegated for utilization management, review referral requests that cannot… more
- Atlantic Health System (Livingston, NJ)
- …plan, including transfer eligibility, level of care, resource prioritization & utilization , timely acceptance, and appropriate priority and mode of transport. Acts ... initiatives as assigned. Accurately completes and transmits all required documentation per policies/procedures. Generates regular and on demand reports as assigned.… more
- RCM Health Care Services (New York, NY)
- Job Description RN Coordinator of Care - CHHA Registered Nurse, Field... of Care Nurse will take on 5 visits per day The orientation / training will take place ... evaluate the home care needs of your patients. You will also review patient insurance information, coordinate activities involved in each individual care plan… more
- VA White River Junction Healthcare System (White River Junction, VT)
- Summary This Blind Rehabilitation Specialist (VIST Coordinator ) position is in Physical Medicine and Rehabilitation services at the White River Junction VA Medical ... Vermont location. Duties Help The Blind Rehabilitation Specialist (VIST Coordinator ) position requires knowledge of the concepts, principles, and...Time Off: 37-50 days of annual paid time offer per year (13-26 days of annual leave, 13 days… more
- Heywood Hospital (Gardner, MA)
- …department policies and procedures, as well as, state and federal regulations. Completes Utilization Review activities and other duties as assigned by Director. ... generous earned time off. Come work where you will matter! Hours: Per Diem, Days/Evenings Job Summary: Responsible for conducting High Risk Screening/Heath Related… more
- UnitedHealth Group (El Paso, TX)
- …financial outcomes and member satisfaction while managing the plan of care. Service Coordinator Level 2 is responsible for overall management of member's case within ... within the time specified as part of contractual guidelines or per Member/family/provider request. Identifies members for high-risk complications and coordinates… more
- Pascua Yaqui Tribe, AZ (Tucson, AZ)
- …is responsible for coordinating clinical services and providing Quality Assessment and Utilization Review (QA/UR) Management for the Pascua Yaqui Maricopa/Pima ... by scheduling appointments, generating purchase orders and explaining procedures. Review medical referrals and claims with assigned committee members; determine… more
- Town of Andover, NA (Andover, MA)
- …Superintendents' Office Opening Date: 05/30/2025 Closing Date: Continuous Minimum Hours per Week: 40 Description Under the direction of the Assistant Superintendent, ... the program coordinator for World Language will be responsible for the...grade levels. Co-facilitate the world language curriculum council to review updated standards and coordinate curriculum mapping, vertical articulation,… more
- Regency Integrated Health Services (Austin, TX)
- …outcomes, and utilization of Data Integrity Audit reports (Point Right) per company policy. Ensures the timely electronic submission of all Minimum Data Sets ... Office and external Case Managers. Gathers information needed for Managed Care Utilization Reviews throughout the resident's stay and communicates this with the… more
- LHC Group, Inc. (Lafayette, LA)
- Job Description Responsible for the timely review of plan of care and OASIS time points in the electronic medical record to ensure accuracy of OASIS items, ... documentation, and utilization for quality and outcome management through clinician collaboration...reviews the medical record as part of the OASIS review process and recommend the most accurate codes, adhering… more
- Glens Falls Hospital (Glens Falls, NY)
- …condition that may necessitate treatment change and will attend regular case review meetings. The Care Manager will work closely with the Interdisciplinary Team ... to ensure appropriate utilization and provision of resources for patients including referrals...In addition to creating/altering the care plan, the Care Coordinator will ensure that a participant/family values assessment is… more
- Compu-Vision Consulting, Inc. (Lawrenceville, GA)
- …Congruent Practice, Ethics, Professional Practice Evaluation and Resource Utilization Leadership Collaboration, Community Involvement, and Environmental Health ... ACLS certification within one year of employment, and renews certification per national standard. Prior to administering chemotherapy, attends a formal chemotherapy… more
- OneLegacy (Azusa, CA)
- …collection of data. The OTL will demonstrate fiscal responsibility with appropriate utilization of clinical resources including staff activity and assignments and by ... into digitalDONOR and DonorNet on referrals and/or cases. Including review of serology report, ABO and labels. Ensures all...case management by performing a minimum of 2 shifts per month in the field. Organ Donation Process Obtains… more
- Shaw University (Raleigh, NC)
- …sites on weekdays and/or weeknights and Saturdays. In addition to the utilization of a variety of teaching strategies, full-time teaching faculty must provide ... office hours. - Each semester, maintains a pre-scheduled minimum of ten hours per week as office hours, including morning and afternoon hours, to provide student… more
- TulaRay (Harrisburg, PA)
- …setting, behavioral health setting, drug and alcohol setting, managed care, quality management/ utilization review or other related clinical experience; or An ... (MA), health care services, human services, long term care, utilization review , or knowledge of home care...coordinator for assigned cases by planning and directing review activities in order to complete the review… more
- Commonwealth Care of Roanoke (Radford, VA)
- …in quality assurance committees: Care Planning Infection Prevention and Control Risk, Utilization Review , Pharmacy, and Safety. Collaborates with DON regarding ... with the Director of Nursing and the DNT Program Coordinator to complete required assignments. ESSENTIAL FUNCTIONS : Reviews...at least one complete skin audit for all patients. Review pharmacy services that includes but is not limited… more
- PRIMORIS USA (Aurora, CO)
- …concerns with Site Manager. Will be responsible within work discipline for the utilization of best safety practices: the management of employee training for work ... (hiring, promoting, disciplining, terminating) trade employees through the proper utilization of company resources, processes, and policies. Assist Site Manager… more
- Rogers Behavioral Health (Oconomowoc, WI)
- …aftercare providers to ensure continuity of care, if warranted. Communicate with the Utilization Review department to provide information necessary to assist in ... will have involvement with managed care companies as needed and coordinate with the utilization review manager or lead. Monitor the safety of the environment… more
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