- Novo Nordisk Inc. (Oklahoma City, OK)
- …obesity to maximize sales within an assigned territory. The Obesity Care Specialist (OCS) must achieve sales goals by implementing marketing and sales strategies ... assess, create and maintain advocacy of customers aligned to company, brand and clinical goals. The OCS develops local strategies and executes local tactical plans… more
- Blanchard Valley Hospital (Findlay, OH)
- …and compliant and optimal charge capture in a time-sensitive manner for designated clinical service lines. Review clinical documentation to ensure charge ... POSITION The primary purpose of the Professional Coding Integrity Specialist (PCIS) is to review , enter and/or...review , enter and/or modify charges as appropriate, including review of clinical documentation to ensure charge… more
- Comhar Inc. (Philadelphia, PA)
- …quality reviews, which shall include chart audits as well as quality review phone calls to consumers. License Clinical Supervisor SPECIFIC DUTIES:Complete ... Health Services (IBHS) has an immediate opening for an License Clinical Supervisor. License Clinical Supervisor Salary: $55,000-$57,000The License IBHS… more
- Compass Health Network (Wentzville, MO)
- …individual treatment plan goalsOther ResponsibilitiesOther miscellaneous duties as assignedPerform Utilization Review activities as assignedAttend all training ... A Pinocchio Specialist is a mental health professional based in...families to other Compass Health services as deemed appropriateDirect Clinical ServicesCollaborate with families and systems to develop Pinocchio… more
- Compass Health Network (Wentzville, MO)
- …treatment plan goalsOther Responsibilities* Other miscellaneous duties as assigned* Perform Utilization Review activities as assigned* Attend all training as ... A Pinocchio Specialist is a mental health professional based in...families to other Compass Health services as deemed appropriateDirect Clinical Services* Collaborate with families and systems to develop… more
- Blanchard Valley Hospital (Findlay, OH)
- …investigational or potential compliance risks. Duty 7: Work with Coding Claims Resolution Specialist (CCRS) to review denial trends, whether coding related or ... compliant and optimal professional charge capture which is supported by clinical documentation. Coordinate with the Professional Coding Integrity Auditor/Educator to… more
- BayCare Health System (Cotton Plant, AR)
- …Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Specialist Senior **Location** Clearwater:Morton Plant | Clinical | Part ... and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and… more
- Trinity Health (Maywood, IL)
- …is Loyola campus. Position is hybrid, must reside in Illinois. The Regional Utilization Review Documentation Specialist nurse works with the ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Utilization Review - RN Reviewer- Regional Coverage for Loyola, Gottlieb and MacNeal… more
- Spectrum Billing Solutions (Skokie, IL)
- …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR ... will utilize his or her knowledge and skills to review clinical information and obtain initial and... information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **Job Summary** The Manager Utilization Review /MediCal Specialist will develop and maintain a full ... of care from pre-admission through post-discharge for Medi-Cal patients. The Manager Utilization Review /MediCal Specialist will manage the program to… more
- Universal Health Services (Groton, CT)
- …Washington, DC, Puerto Rico and the United Kingdom. www.uhs.com Job Summary: The Utilization Review Specialist is responsible for the pre-certification, ... (UHS), has an immediate opening for a full-time UR Specialist . Stonington Institute is committed to providing quality substance...or related Human Service Field or RN. Knowledge of Utilization Review Processes, insurance plans, mental health… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties ... include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency...times. + Addresses care issues with the Director of Clinical Services and Chief Medical Officer/Medical Director as appropriate.… more
- Insight Global (Boston, MA)
- …facilities under the provisions of benefits plan. The LTSS Service Authorization Specialist is responsible for applying clinical and benefit administration ... Job Description Clinical Effectiveness (Authorization) Unit is primarily responsible for...Term Services and Supports (LTSS). The LTSS Service Authorization Specialist provides accurate, prompt, and appropriate medical authorizations to… more
- Truman Medical Centers (Kansas City, MO)
- …into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Specialist 101 Truman Medical Center **Job ... training, coaching and consulting to outside organizations. **Job Description** The Utilization Specialist will verify all financial and insurance information,… 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 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve… more
- University of Virginia (Charlottesville, VA)
- As a Medication Utilization , Formulary, and Policy Specialist , you will play a crucial role in optimizing medication management practices UVA. The primary focus ... position is to manage the completion of formulary activities, support medication utilization projects, and ensure timely policy management within the department of… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Physician Specialist collaborates with the healthcare team in the management and resolution of activities that ... population and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- Immigration and Customs Enforcement (IN)
- …Director for Healthcare Compliance, Office of Health Plan Management. The Senior Utilization Review Consultant will report directly to the IHSC Regional ... position Responsibilities DUTIES AND RESPONSIBILITIES: Serves in the capacity of Senior Utilization Review Consultant and subject matter expert in program… more
- Robert Half Office Team (Monterey Park, CA)
- Description The Utilization Management Nurse Specialist LVN promotes the quality and cost effectiveness of medical care by applying clinical acumen and the ... clinical judgment and refer to Medical Directors for review depending on case findings. Functions & Job Responsibilities...on case findings. Functions & Job Responsibilities * The Utilization Management Nurse Specialist LVN will facilitate,… more
- Alameda Health System (San Leandro, CA)
- … utilization and an appropriate level of care. 5. Coordinates all utilization review functions, including response to payor requests for concurrent and ... continued stay using evidence from the medical record and clinical review tools, as well as input...of Case Management experience in an acute setting or utilization review at a medical group or… more
