- OU Health (Oklahoma City, OK)
- Position Title:Manager Case Management Utilization Review - OU Medical CenterDepartment:Case ManagementJob Description:General Description: Under direction, the ... to promote cost-effective outcomes.Assists in developing and implementing the Utilization Plan, departmental goals, and departmental policies and procedures.Evaluates… more
- The University of Vermont Health Network (Plattsburgh, NY)
- …Department at Champlain Valley Physicians Hospital (CVPH) in Plattsburgh, NY.GENERAL SUMMARY:The Utilization Review RN monitors, collects and analyzes data and ... quality of care based on benchmarked criteria or established practices. The Utilization Review RN in utilizing these skills assists the Medical Center in… more
- Medical Solutions (Glendale, CA)
- Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Glendale, California.Job Description & ... tax-free stipend amount to be determined. Posted job title: Case Management ( Utilization Review )About Medical SolutionsAt Medical Solutions, we're people who… more
- APN Consulting, Inc (Remote, OR)
- …the Utilization Management team primarily responsible for inpatient medical necessity/ utilization review and other utilization management activities ... Job Title: Care Review Clinician Location: Remote (Must possess a CA...Client policy for Client members as part of the Utilization Management team* Identifies appropriate benefits, eligibility, and expected… more
- APN Consulting, Inc (VA)
- …the Utilization Management team primarily responsible for inpatient medical necessity/ utilization review and other utilization management activities ... Job Title: Care Review Clinician I Location: Remote Duration: 6 Months...Client policy for Client members as part of the Utilization Management teamIdentifies appropriate benefits, eligibility, and expected length… more
- US Tech Solutions, Inc. (Columbia, SC)
- … practices. May provide any of the following in support of medical claims review and utilization review practices: Performs medical claim reviews and ... to members and their families/caregivers. Reviews first level appeal and ensures utilization or claim review provides thorough documentation of each… more
- University of New Mexico - Hospitals (Algodones, NM)
- This is a Utilization Review position. We review all admissions and continued stay to the hospital for Medical necessity and manage the insurance ... patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary * VARIANCE… more
- Spectraforce Technologies (Columbia, SC)
- …Responsibilities: 80% May provide any of the following in support of medical claims review and utilization review practices: Performs medical claim reviews ... and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices.… more
- CHRISTUS Health (Alamogordo, NM)
- …status and assists him/her in ensuring proper placement of patient. Conducts utilization review using nationally recognized medical necessity criteria and ... there are actual or potential sources of under- or over- utilization . Collaborates with providers, nurses, patients, families, and other...documents the review . Refers cases for second level reviews when medical… more
- Blanchard Valley Hospital (Findlay, OH)
- …and coordination of care, as needed. Duty 10: The Social Worker performs ongoing utilization review of patients admitted to the psychiatric unit to ensure ... in various committees and meetings to contribute information regarding utilization of services and quality of healthcare for the...appropriate levels of care and utilization of services are maintained, to avoid penalties, and… more
- NorthBay Health (Fairfield, CA)
- …for all aspects of Care Management and Population Health which includes: Utilization Management, Utilization Review , Inpatient, Outpatient and Complex ... and implements key processes to maximize efficiency of resource utilization . They will assume overall responsibility for coordinating/managing patient centered… more
- Christus Health (Alamogordo, NM)
- …patient status and assists him/her in ensuring proper placement of patient.Conducts utilization review using nationally recognized medical necessity criteria and ... there are actual or potential sources of under- or over- utilization .Collaborates with providers, nurses, patients, families, and other care...documents the review .Refers cases for second level reviews when medical necessity… more
- Integrated Resources, Inc (Temecula, CA)
- …Pay rate: $50/hr.- w2 - $60/hr.- w2. Job Description: . Case management RN / Utilization Review experience required in Inpatient Hospital. . Unit: 87510 - ... Utilization Review . Desired Shift: DAYS - 8 HR: 8:30a-5p . A Registered Nurse (RN) Case Manager plays a crucial role in the healthcare system, particularly in… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of individual patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team to ... as needed to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure patients are in… more
- Southeast Georgia Health System (Brunswick, GA)
- …to convey same to physicians/office staff. Assists the Manager with validating that utilization review processes are conducted as outlined in the Utilization ... Plan. Coordinates patient's appeals to the Quality Improvement Organization (QIO) ensuring timely medical record submission and tracking of QIO decision. Responsible for data compilation regarding length-of-stay, avoidable days and readmissions, and the… more
- University of New Mexico (Albuquerque, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary* VARIANCES - ... Days Position Summary:Supervise case manager social work staff. Responsible for the initial review , triage and assignment of patients to case managers and for the… more
- University of New Mexico - Hospitals (Algodones, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary * VARIANCE ... FTE: 1.00 Full Time Shift: Days Position Summary: Responsible for the initial review , triage and assignment of patients to case managers and for the coordination… more
- Comhar Inc. (Philadelphia, PA)
- …this individual supervision a chart review should be completed using the updated Utilization Review sheet with particular attention paid to whether or not a ... PGP exists to cover the time period since the last CBH review . Daily monitoring of the 30 day contact board and if a contact is due make sure that the contact is… more
- Comhar Inc. (Philadelphia, PA)
- …this individual supervision a chart review should be completed using the updated Utilization Review sheet with particular attention paid to whether or not a ... PGP exists to cover the time period since the last CBH review .Daily monitoring of the 30 day contact board and if a contact is due make sure that the contact is… more
- Rose International (Long Beach, CA)
- …and physician filings and decisions on appropriate treatments recommended by utilization review * Maintains professional client relationships Additional ... 60.00 Max Hourly Rate ($): 60.00 Must Have Skills/Attributes: Claims, Document Review , Negotiation Job Description **Only those lawfully authorized to work in the… more
Related Job Searches:
Case Management Utilization Review,
Medical Utilization Review,
Registered Nurse Utilization Review,
Utilization,
Utilization Review Case Manager,
Utilization Review Coordinator,
Utilization Review Nurse,
Utilization Review Nurse RN,
Utilization Review RN,
Utilization Review Specialist