- Capital Health (Trenton, NJ)
- … review and determination. Gathers clinical information to conduct continued stay utilization review activities with payers on a daily basis. Performs ... flow barriers using the Avoidable Days tool in the Utilization software program. Consults with medical staff, care...years of clinical nursing or two years quality management, utilization review or discharge planning experience. Other… more
- VCU Health (Richmond, VA)
- The Utilization Review RN is responsible for utilization management and utilization review for prospective, concurrent, or retrospective review . ... team, including physicians, social workers, discharge planning assistants and payers. The Utilization Review RN performs reviews of current inpatient services,… more
- Franklin Woods Ctr (Rosedale, MD)
- …Associates, Inc. is seeking a skilled and detail-oriented Registered Nurse - Utilization Management (UM) to review healthcare services, ensure clinical ... appropriateness, and coordinate effective patient care within regulatory guidelines. Job Responsibilities Review patient medical records, treatment plans, and… more
- Kings View Corporation (Fresno, CA)
- …services to the underserved community, is currently seeking a driven Clinical Supervisor- Utilization Review to join our mission to provide compassionate services ... with integrity while listening and responding to the community in need. Clinical Supervisor- Utilization Review (280) Fresno, CA The Clinical Supervisor is part… more
- Trinity Health - IHA (Rochester, MI)
- … care and services of selected member populations across the continuum of care , promotes effective utilization and monitoring of health care resources, ... or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position. Care Management Metrics including productivity… more
- Providence Health & Services (Seattle, WA)
- …teams, both internal and external to the organization, to improve patient care through effective utilization and monitoring of healthcare resources and ... and uses creative problem solving for complex discharge planning, quality of care , and utilization issues. Explores new resources when the opportunities… more
- Memorial Hermann Health System (Houston, TX)
- …and closure of gaps in care . Promotes timely access to appropriate care and promote effective and efficient utilization of clinical resources. Promotes ... adherence to an established plan of care . Increases utilization of primary ...through appropriate education. Provides medication management, including comprehensive medication review and make recommendations to primary care … more
- HCA Healthcare (Kansas City, MO)
- …a data-driven environment of quality and cost improvement and develops systems to review utilization of resources and objectively measure outcomes of care ... for appeals and denials process, discharge planning, case management, and utilization review /management. Consults with facility-level staff regarding delegated … more
- Alexandria Care Center (Los Angeles, CA)
- …will play a pivotal role in ensuring residents and their families receive appropriate care coordination and utilization of services to ensure the highest quality ... $38.00 - $45.00 hourly rate. We are passionate about providing high-quality care and fostering a compassionate, family-oriented environment. We believe in building a… more
- Northern Light Health (Brewer, ME)
- …appropriate Names, dates, and times of conversations with businesses, insurances, managed care organizations, Utilization Review , and patients are ... Northern Light Eastern Maine Medical Center Department: Primary Care - Brewer Position is located: Northern Light Health Center Brewer Work Type: Full Time Hours Per… more
- ADELANTE HEALTHCARE INC (Surprise, AZ)
- …health outcomes reporting, clinical audits, and programmatic evaluation. Assist in clinical care by providing utilization of resources, and development of new ... Time Education Level HS Diploma from accredited school Job Category Health Care Description POSITION SUMMARY The Medical Assistant provides direct patient care… more
- Vassar Brothers Medical Center (Poughkeepsie, NY)
- …Brothers Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of ... cardiology care . Non-acute care is offered through various... to an assigned group of patients through the utilization Standards of Practice and policies and procedures and… more
- Team Select Home Care (Covina, CA)
- …Control Plan, EMS Plan and the Compliance Plan Participates in clinical record/ utilization review of medical records and quality assurance and performance ... A Registered Nurse (RN) administers skilled nursing care to patients on an intermittent basis in...also for current CPR Able to maintain licensure and continuing education as applicable Excellent verbal and written communication… more
- Riveon Mental Health and Recovery (Elyria, OH)
- …and implementation of all CQI corrective actions as assigned. Monthly participation in the Utilization Review and Peer Review programs. Other duties as ... we have the opportunity to provide integrated behavioral health care with cutting edge treatments and interventions in a...Leave Paid Jury Duty Time Parental Leave Company Supported Continuing Education & Certification PPO & HDHP Health Plan… more
- Premier Health (Eaton, OH)
- …standards for administration and reporting of outcome measures and documentation of utilization management of clinical care . *Demonstrate knowledge of other ... and staff meetings. *Meet regularly with clinical director and as needed to review clinical care of patients according to licensing and agency standards.… more
- Rep-Lite (Charleston, SC)
- …and care teams Provide strategic support for multidisciplinary case review meetings to help identify eligible patients Partner with cross-functional teams to ... conditions. You will be responsible for expanding awareness, increasing treatment utilization in established accounts, and building a strong network of referring… more
- Kroger (Louisville, KY)
- Job Description Responsible for delivering the highest quality health care within The Little Clinic's scope of services while achieving optimum patient satisfaction. ... with the patients, host store personnel and the health care community in order to enhance practice building and...maintaining all company metrics for productivity Participate in peer review , quality assurance, and staff meetings with other health… more
- Pioneer Valley Hospice and Palliative Care (Greenfield, MA)
- …planning, implementing, and evaluating phases of the nursing process by coordinating care on weekends. Through the utilization of hospice and community ... RN Weekend Coordinator - Pioneer Valley Hospice & Palliative Care Weekly Pay | Mileage Reimbursement Salary Range: $38.00 - 47.97/hr with an additional $7 per hour… more
- UT Southwestern Medical Center (Dallas, TX)
- …the service area, providing medical expertise and supporting the Department's continuing recruitment efforts. ESSENTIAL FUNCTIONS Serves as the designated leader in ... the area of service and actively works to prevent disparity in patient care . Develops, revises, and monitors annual goals and objectives of the service area of… more
- University of Toledo Physicians (Toledo, OH)
- …Demonstrates competence of the practice outlines with the SCA using methods of quality care review , periodic peer review , and clinical outcomes evaluations ... mission is to improve the human condition through excellence in patient care and medical discovery. Representing more than 200 physicians, UT Physicians are… more
