- Staffing Now (Norfolk, VA)
- …precertification, prior authorization, and post service requests. Refers cases requiring clinical review to a Nurse reviewer . Responsible for the identification ... openings! Responsible for coordinating cases for precertification and prior authorization review . Primary duties may includes, but are not limited: Managing incoming… more
- University Medical Center of El Paso (El Paso, TX)
- Job Description: Assists in development of services, policies, procedures related to Utilization Management / Utilization Review . Collects and analyzes ... service excellence. Required Skills: Knowledge of managed care, reimbursement and utilization management . Demonstrates ability to analyze related information,… more
- Staffing Now (Norfolk, VA)
- …precertification, prior authorization, and post service requests.Refers cases requiring clinical review to a Nurse reviewer .Responsible for the identification ... $17/hour Responsible for coordinating cases for precertification and prior authorization review . Primary duties may includes, but are not limited:Managing incoming… more
- Cambia Health Solutions, Inc (Portland, OR)
- …a member of the Behavioral Health team, our Clinicians provide utilization management (such as prospective concurrent and retrospective review ) to best meet ... Behavioral Health Utilization Management Clinician Work from home...prospective, concurrent, and retrospective assessments, to ensure adherence to medical necessity and policy standards.Applies clinical expertise and evidence-based… more
- GHR Healthcare (Atlanta, GA)
- …Pay Rate: 37.50 -40.00 Hourly (paid weekly) What You'll Do: Clinical Analysis: Review medical records to determine the necessity of patient services based ... a detail-oriented RN with a knack for navigating complex medical cases? Do you thrive on making critical decisions...that impact patient care? Join us as a Care Management Coordinator and play a key role in evaluating… more
- Equiliem (Orange, CA)
- …the Medical Director's decision and documents follow-ups in the utilization management system. Completes required documentation for data entry into ... the Medical Director's decision and documents follow-ups in the utilization management system. Completes required documentation for data entry into… more
- US Tech Solutions, Inc. (Columbia, SC)
- …Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits ... . May provide any of the following in support of medical claims review and utilization review practices: Performs medical claim reviews and makes a… more
- RIVET OPERATIONS COMPANY LLC (San Diego, CA)
- …, monitor and analyze data received from ashore aviation units.Initiate and review configuration management and outfitting directives, develop AVCAL and SHORCAL ... and a leader in physical and cyber security, IT management , logistics, supply chain management , process improvement...product listings, and review IMRL listing for accuracy. Review , analyze, and… 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 ... assure patient management that efficiently and effectively aligns with patient needs...to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent… more
- Lennar Homes (Irving, TX)
- …the adoption of quality platforms, and leading engagements with leadership to review and enhance quality KPIs. Additionally, this role will introduce Data Quality ... dreams come true.A career built on building zero defect homes, cost management , and adherence to schedules. Your Responsibilities on the Team Design, implement,… more
- zobility (Indianapolis, IN)
- …requirements necessary to maintain configuration control and meet quality management system standards, promotes efficient, collaborative, and timely CM workflow, ... coordinates document and data deliverable management , identifies and troubleshoots anomalies, demonstrates and promotes analytical thinking, and capably communicates… more
- Sonora Quest (Sterling, CO)
- …the appropriate use of supplies and materials and assists with inventory management . Ensures efficient utilization of reagents and supplies. Recognizes and ... based on education & experienceIn accordance with State Pay Transparency Rules.Calling all Medical Lab Technicians! Come do great work on behalf of better health in… more
- Pacer Staffing (Atlanta, GA)
- …description Job Summary This individual contributor position reports to the Directors of Utilization Management (UM) and Referral Management (RM) and ... Nurse, with current unrestricted license in appropriate state . 4+ years Utilization Management experience . Proficient at in-depth analysis of clinical… more
- Blanchard Valley Health System (Findlay, OH)
- …the Acute Care Transitions Team, including the disciplines of Social Work, Case Management , Utilization Review , and Emergency Department Care Navigation to ... of appropriate services during acute care stay. Duty 9: Maintains position as Utilization Review committee chair. Works in collaboration with ambulatory care… more
- Engage Partners, Inc. (Orange, CA)
- …based, trauma informed, and culturally competent services. Ensure charts meet quality management standards per monthly utilization review and/or chart ... in a timely manner. Responsible for direct report performance management including, performance improvement plans, formal written warning notices. Delivers… more
- NorthBay Health (Fairfield, CA)
- …for all aspects of Care Management and Population Health which includes: Utilization Management , Utilization Review , Inpatient, Outpatient and ... Complex Case Management , Discharge Planning, Denial Management , and Social Services for the NorthBay Healthcare Group. This director will collaborate with… more
- Pacer Staffing (Atlanta, GA)
- …regulatory requirements, and HIPAA privacy regulations. . Thorough knowledge of Case Management , Utilization Management , HIPAA Privacy and Security ... Job Summary . Provides Disease Management (DM) services to TRICARE beneficiaries. . The...and Medicare/Medicaid Key Responsibilities . Assess beneficiaries to identify medical , physical, and psychosocial needs to support the beneficiaries'… more
- Northeast Georgia Health System, Inc (Demorest, GA)
- …designs proactive discharge plans utilizing a team approach as demonstrated by cost management of patient stay and utilization for outside resources. Contributes ... with medical and department staff as evidenced by peer review and observation. Demonstrates flexibility by pro-actively resolving conflicts, scheduling problems,… more
- Careers Integrated Resources Inc (Milwaukee, WI)
- …as necessary. . Performs inspection, preventative maintenance and electrical safety of medical technologies. Review outcome of preventive maintenance actions and ... documentation. . All work is performed and documented in accordance with the Imaging Medical Equipment Management Plan. . Participates in new system or new… more
- Volunteers of America Mid-States (Louisville, KY)
- …and Wellness Employee Assistance Plans (EAP) Health and Wellness Program Medical Coverage Dental Coverage Vision Coverage Flexible Spending Account Health Spending ... AND QUALIFICATIONS: Service Coordinator will be responsible for ensuring maximum utilization of community resources by residents of Volunteers of America Mid-States'… more
