- NHS Management (Madison, AL)
- …in maintaining resident care standards related to quality assurance, infection control, and utilization review Receive and communicate physician orders and ... ensure proper implementation across units Oversee delegation of nursing and therapeutic procedures to licensed and unlicensed staff Conduct regular resident rounds to assess physical conditions, behaviors, and quality of care Ensure accurate documentation of… more
- NHS Management (Athens, AL)
- …through oversight of quality assurance, infection control, and utilization review activities Receive and communicate physician instructions related to ... resident care and ensure orders are implemented appropriately Oversee delegation of nursing and therapeutic procedures within LPN scope of practice Conduct regular resident rounds to assess physical condition, behaviors, and overall care quality Ensure… more
- HCA HealthONE Rose (Denver, CO)
- …on unit and staff performance issues needing attention. Maintains effective utilization and maintenance of manpower, equipment, and supplies. Other duties as ... CareNow urgent care clinics, mental health campuses, imaging and surgery centers, physician practices, home and hospice care, and AirLife Denver, which provides… more
- NHS Management (Huntsville, AL)
- …facility policies and procedures Support quality assurance, infection control, and utilization review activities during night operations Receive, communicate, ... and implement physician orders as needed Oversee delegation of nursing and therapeutic procedures to licensed and unlicensed staff Conduct regular patient rounds to… more
- Hackensack Meridian Health (Hackensack, NJ)
- The Utilization Review Physician collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical ... Hackensack University Medical Center. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… 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 ... population and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- CommonSpirit Health (Phoenix, AZ)
- …by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. + Physician Advisor Sub-specialty Certification ... This role will be an expert on matters regarding physician practice patterns, over and under- utilization of...by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. **Required… more
- Trinity Health (Des Moines, IA)
- …Process Improvement. Physician Relationships. Hospital Management and operations. Utilization review / physician advisor Graduate Medical Education ... a matrixed relationship for centralized medical staff functions such as quality, safety and utilization review and to the RHM President and other members of the… more
- Hackensack Meridian Health (Hackensack, NJ)
- …(APN) or Physician Assistant (PA) for the Transition Utilzation Review Team utilizes a patient-centered coordinated care model, demonstrating competencies in ... Knowledge, Skills and Abilities Required: 1. Successful completion of an approved physician 's assistant program, accredited by the AMA Council on Medical Education.… more
- Atlantic Health System (Summit, NJ)
- …from ABQAURP (The American Board of Quality Assurance and Utilization Review Physicians), AAPL (American Association for Physician Leadership's Physician ... in Management course), or CPUR (Certification Program in Utilization Review ), Institute for Healthcare Improvement courses, or physician advisor training… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE ... see comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're… more
- Huron Consulting Group (Chicago, IL)
- …Management is responsible for planning, organizing, developing, and directing implementation of the Utilization Review Plan and the overall operation of the ... located in Annapolis, MD + Staff Acquisition and Support: Leads and manages the utilization review staff and function for the system, reporting to the Director… more
- St. Peters Health (Helena, MT)
- …with the MD advisor or physician consultant(s) on any cases sent for physician review . 4. Performs daily utilization reviews on all patients admitted ... The Utilization Management RN reports directly to Utilization Review RN Coordinator. The UR RN...reviews according to UR work plan and follow-up with physician consultants. 13. Confirm admission diagnosis and correct admission… more
- The County of Los Angeles (Los Angeles, CA)
- …Organization guidelines and the Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...by subordinate supervisors on number and status of reviews, physician advisor referrals, and type of physician … more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.This is a full-time role and will be required to work ... this position: *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case Management -...based on Medical Necessity and submits case for Secondary Physician review per Tenet policy Ensures timely ... care and appropriate level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. (5% daily,… more
- Integra Partners (Troy, MI)
- …operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director(s), ensures consistent application of criteria, ... Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director's responsibilities include but are not… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr - CMC - Clear Lake Center - M-F, 8:00 AM - 5:00 PM **Webster, Texas, United States** Nursing & Care Management UTMB Health ... or observation in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and retrospectively… more
- Beth Israel Lahey Health (Plymouth, MA)
- …and identifies trends/root causes of denials for discussion with the internal team, physician advisor and the Utilization Review Committee as appropriate. ... you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We Are:** At… more
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