- FLACRA (Clifton Springs, NY)
- Utilization Management Specialist FLACRA Clifton Springs, NY (Onsite) Full-Time $16.50 - $17.50/Hour Apply Now ... (https://flacra.jobs.net/apply/jqn6gn6t2h294xv9ngh?ipath=CR¬ify=true&siteid=cbnsv) Job Details Job Title: Utilization Management Specialist Location:Finger Lakes… more
- Penn Medicine (Lancaster, PA)
- …Medicine Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this critical role, you'll advocate ... under pressure, we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions is responsible for evaluating medical records… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Spectrum Billing Solutions (Skokie, IL)
- …mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist | Revenue ... Specialist | ABA Utilization Review Specialist | ABA Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing … more
- AnMed Health (Anderson, SC)
- …here. This position is responsible for performing the daily operations of the Utilization Management program at AnMed within the Care Coordination model. These ... necessity review, continued stay/concurrent review, retrospective review, bed status management , resource utilization management , regulatory compliance,… more
- UnityPoint Health (Cedar Rapids, IA)
- …ID: 174223 Overview This position is on site at St. Luke's Hospital. The Utilization Management Specialist in the Behavioral Health Hospital Outpatient ... optimal clinical outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management function for patients admitted to BH… more
- Penn State Health (Hershey, PA)
- …(MAILTO://###@pennstatehealth.psu.edu) **SUMMARY OF POSITION:** Under the direction of a Utilization Management Nurse or Specialist , the ... or outlaw discrimination._ **Union:** Non Bargained **Position** UM Coordinator - Utilization Management **Location** US:PA: Hershey | Clerical and… more
- Community Health Systems (Franklin, TN)
- …appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission and continued ... **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for...extended stays, identifying opportunities for process improvements to enhance utilization management . + Serves as a key… more
- BriteLife Recovery (Englewood, NJ)
- …compliance. + Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials, approvals, ... What you will be doing? The Utilization Review (UR) Specialist is a...you? + Minimum of 2-3 years of experience in utilization review, case management , or insurance coordination… 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
- TEKsystems (Los Angeles, CA)
- …Vocational Nurse (LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare claims ... LVN or RN license (California) + 2+ years of experience in Utilization Management (UM) + Hands-on experience with HMO/Medicare claims, audits, and denials +… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... financial, and utilization goals through effective management , communication, and...appropriate * Collaborates with department director and professional development specialist to develop standard work and expectations for the… more
- St. Peters Health (Helena, MT)
- The Utilization Management RN reports directly to Utilization Review RN Coordinator. The UR RN supports the UR RN Coordinator and other UR team members in ... collaborative and supportive liaison and educator to providers and staff around utilization management principles. This professional role will be responsible… more
- Katmai (Usaf Academy, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... background checks. **DESIRED QUALIFICATIONS & SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in Healthcare… more
- Community Health Systems (Franklin, TN)
- …reduce potential denials, utilizing input from the Utilization Review Clinical Specialist . + Monitors and updates case management software with documentation ... preferred **Knowledge, Skills and Abilities** + Strong knowledge of utilization management principles, payer requirements, and healthcare regulations.… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary services + Perform other duties as assigned by the… more
- UNC Health Care (Kinston, NC)
- …of applied clinical experience as a Registered Nurse required. + 2 years utilization review, care management , or compliance experience preferred. + Minimum 1 ... the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying established criteria to… more
- Commonwealth of Pennsylvania (PA)
- Drug & Alcohol Case Management Specialist (Local Government) - Delaware County D&A Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5144215) ... Apply Drug & Alcohol Case Management Specialist (Local Government) - Delaware County...personal visits, and review of treatment progress reports; conduct utilization review. Orient clients to the program, policies, procedures,… more
- University of Colorado (Aurora, CO)
- **IT Principal Professional (EPIC/PACS Data Management and Analytics Specialist )** **Description** **University of Colorado Anschutz Medical Campus** ... **Department: Radiology** **Job Title:** **IT Principal Professional (EPIC/PACS Data Management and Analytics Specialist )** **Position #: 00840831 - Requisition… more