- Henry Ford Health System (Detroit, MI)
- The Medical Director of Utilization Review is responsible for the medical oversight of activities related to appropriateness of Henry Ford Hospital (HFH) ... utilization of hospital resources, and continued stays of inpatients. The Medical Director of utilization review will ensure the most efficient use of the… more
- SUNY Upstate Medical University (Syracuse, NY)
- … Review Denials Review Unit (DRU) 3 Team Lead will assist the Director of Utilization Review and the Associate Director of Utilization ... and provides feedback/mentorship to UR CR I as to review , payor and regulatory questions. This UR DRU 3...clinical conceptual understanding for purposes of level of care review . Strong communication skills, both written and verbal, as… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- POSITION TITLE: Utilization Review Clinician REPORTS TO (TITLE): Director of Utilization Review DESCRIPTION OF POSITION: Work as member of ... to third party payers. + Recordkeeping: Maintains appropriate records of the Utilization Review Department. + Training: Provide staff in-service training and… more
- AdventHealth (Maitland, FL)
- …assigned by the Division CFO/SrVP, Vice President of Revenue Cycle Operations and/or Director , Utilization Review Management..Reviews data and trends to ... in review of long stay patients, in conjunction with the Director of Utilization Review Management to facilitate the use of the most appropriate… more
- UCLA Health (Los Angeles, CA)
- …timely communication is provided to all stakeholders. + Working closely with medical director , utilization management and quality review team to ensure ... Description As the Utilization Management & Quality Review Specialist, you will be responsible for: + Managing service requests and potential quality issue… more
- AnMed Health (Anderson, SC)
- The Utilization Review Medical Director supports operations and direction of the Care Coordination, Clinical Documentation, and Utilization Management ... consultation to the leadership and staff who perform the functions of Utilization Management (UM), Case Management (CM), Transition Planning/ Discharge Planning, and… more
- St. Luke's University Health Network (Allentown, PA)
- …registrations and/or physician queries + Serves as liaison between Physician Advisor/Medical Director , Finance, Utilization Review Department and CDCI. ... of cases lost with feedback to respective departments + Conduct concurrent review with utilization review department for post op surgical cases with… more
- BrightSpring Health Services (Canton, OH)
- …days of death and submit to State Health Services Director and Assigned Director , Clinical Practice* Review utilization report at least monthly to ensure ... are coordinated with behavioral and programmatic staff in partnership with the Executive Director . The Director of Nursing is accountable for overseeing the… more
- Commonwealth Care Alliance (Boston, MA)
- …The Manager, Utilization Management reports to the Director of Utilization Management * Oversees clinical decision review for services requiring prior ... Utilization Mgmt Essential Duties & Responsibilities:...Maintains and optimizes Standard Operating Procedures related to authorization review * Ensures timely and accurate communications of medical… more
- Lakeview NeuroRehabilitation Center (Waterford, WI)
- …facility. This role includes direct involvement in patient care coordination, discharge planning, and utilization review . The Director will manage a team of ... The Director of Case Management is responsible for the...patient-centered care and advocate for patient rights and needs. Utilization Review and Compliance + Monitor and… more
- Trinity Health (Boise, ID)
- …level reviews for patients not meeting inpatient criteria. C. Participates in local Utilization Review Committee and be a member of appropriate committees and ... is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This...accurate reporting of bed status. F. Assist case managers, utilization review nurses and social workers to… more
- Arms Acres (Bronx, NY)
- …life skills) as identified in patient treatment plans and requested by program director . Performs utilization review , provides progress reports and develop ... implementation of the multidisciplinary treatment plan; coordinates treatment plan review ; performs these activities within established time frames. Documents… more
- Ascension Health (Nashville, TN)
- …initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully insured clients to ... Thomas hospitals throughout the TN market. We're looking for an experienced Director of Utilization Management to join our team! In this pivotal role, you'll… more
- Prime Healthcare (Ontario, CA)
- …Clinical Utilization Management (UM) provides comprehensive oversight of the Utilization Review process for the self-insured Employee Health Plans, according ... needs. + Provides strategic leadership, development, and supervision to utilization review department, provides interprofessional collaboration with… more
- Ascension Health (Tulsa, OK)
- …initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for all self-funded and fully insured clients to ... professional licensure at time of hire. **Additional Preferences** + Strong Utilization Review experience + Exceptional communication skills + Leadership… more
- Covenant Health Inc. (Louisville, TN)
- Overview Utilization Review Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift Peninsula Overview: Peninsula, a division of Parkwest ... from ongoing review or retrospective utilization data. + Monitors current utilization review criteria and length of stay norms. + Assists with education… more
- Trinity Health (Silver Spring, MD)
- …Type:** Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review , under the supervision and in collaboration with the ... Director , is responsible and accountable for the operational management,...activities of hospital staff in inpatient care coordination and utilization review . Oversees interactions of staff with… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …to the treatment team, Director of Utilization Management, and the Medical Director . + Review charts at identified review points and attend treatment ... benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and promoting optimal… more
- Behavioral Center of Michigan (Warren, MI)
- Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination, implementation and reporting of complex ... and supports the operations of Samaritan Behavioral Center. The Utilization Review Coordinator reviews the patient's chart...tasks requested by the UR Manager, CEO or Medical Director to meet the needs of the Center. Perform… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more