• Utilization Review

    New York State Civil Service (New York, NY)
    NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator , (NY HELPS), Manhattan Psychiatric Center, P25289 Occupational Category ... Class Competitive Class Travel Percentage 0% Workweek Mon-Fri Hours Per Week 40 Workday From 6 AM To 6...State NY Zip Code 10035 Duties Description As a Utilization Review Coordinator , your duties… more
    New York State Civil Service (01/30/25)
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  • Utilization Review

    Behavioral Center of Michigan (Warren, MI)
    Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination, implementation and reporting of ... and supports the operations of Samaritan Behavioral Center. The Utilization Review Coordinator reviews the...processes requests for appeal of denials. Responds to complaints per UR guidelines. Maintains utilization review more
    Behavioral Center of Michigan (01/21/25)
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  • Care Coordinator , Utilization

    Hackensack Meridian Health (Neptune, NJ)
    …**Hackensack Meridian** **_Health_** includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... serve as a leader of positive change. The **Care Coordinator , Utilization Management** is a member of...as required by payer agencies and initiates physician advisor's review as necessary for unwarranted admissions. + Performs chart… more
    Hackensack Meridian Health (01/17/25)
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  • Care Coordinator , Utilization

    Hackensack Meridian Health (Holmdel, NJ)
    …at Hackensack Meridian _Health_ includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... serve as a leader of positive change. The **Care Coordinator , Utilization Management** is a member of...as required by payer agencies and initiates physician advisor's review as necessary for unwarranted admissions. + Performs chart… more
    Hackensack Meridian Health (11/14/24)
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  • Utilization Review

    UCHealth (Aurora, CO)
    …UCHlth CeDAR, US:CO:Aurora Department: CeDAR Administration FTE: Full Time, 1.0, 80.00 hours per pay period (2 weeks) Shift: Days Pay: $24.11 - $36.17 / hour. ... Pay is dependent on applicant's relevant experience Summary: Facilitates coordination of reimbursement processes for all levels of care to include authorizations, data collection and tracking, internal and external communications. Responsibilities: + Manages… more
    UCHealth (11/28/24)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...title, beginning and ending dates, number of hours worked per week, and description of work performed.If your application… more
    The County of Los Angeles (12/29/24)
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  • Utilization Review Coord

    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 ... services and assigns initial number of days / sessions per third party payor requirements. + Works collaboratively with...or retrospective utilization data. + Monitors current utilization review criteria and length of stay… more
    Covenant Health Inc. (01/31/25)
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  • PRN Utilization Review Clinical…

    Community Health Systems (Franklin, TN)
    …appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for ... position will vary with work up to 40 hours per week. **Essential Duties:** + Initial clinical assessments, continued...documentation from the physician(s). + Escalates cases to the Utilization Review Manager and/or Physician Advisor if… more
    Community Health Systems (01/19/25)
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  • RN- Utilization Review - HS Case…

    Baptist Memorial (Jackson, MS)
    Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed ... by utilization review standards. The UR Nurse works...Responsibilities + Completes and enters inpatient and observation admission review against standard criteria per payer guidelines… more
    Baptist Memorial (01/16/25)
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  • Registered Nurse (RN) - Utilization

    Dartmouth Health (Lebanon, NH)
    Overview Utilization Review (RN) - Remote Works...$20,000. * We offer Relocation Assistance and a Housing Coordinator to take on the burden of finding a ... Remote * Area of Interest:Nursing * Pay Range:$79,747.20/Yr. - $127,587.20/Yr. * FTE/Hours per pay period:1.00 - 1.00 - 40 hrs/week * Shift:Day * Job ID:29683… more
    Dartmouth Health (01/25/25)
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  • Clinical Care Coordinator -Unit (RN),…

    Nuvance Health (Danbury, CT)
    …principal liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate ... per diem Shift: variable Summary: The Clinical Care Coordinator - Unit is responsible for providing direction and...level within the care continuum. Provides clinically based concurrent review of the medical record to assess and procure… more
    Nuvance Health (12/11/24)
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  • Care Coordinator - St. Peter's Hospital…

    Trinity Health (Albany, NY)
    **Employment Type:** Part time **Shift:** Rotating Shift **Description:** **Care Coordinator - St. Peter's Hospital - Per Diem - Rotating** Under the direction ... the treatment and discharge plan. + Collaborate with clinical care teams to review for medical necessity and medical appropriateness of mental health and chemical… more
    Trinity Health (01/25/25)
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  • Asset Coordinator & Airport Systems…

    City and County of San Francisco (San Francisco, CA)
    …SFO teams. For more information about this position, please review the 1844 Asset Coordinator Job Description ... - $129,454 Annually. + Work Schedule: Full-time, 40 hours per week. Shift times will vary, and employees must...SFO teams. For more information about this position, please review the 1844 Airport Systems Coordinator Job… more
    City and County of San Francisco (01/15/25)
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  • Caregiver Support Program Coordinator

    Veterans Affairs, Veterans Health Administration (Spokane, WA)
    …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Contact ###@va.gov for questions. Responsibilities Social ... track service activities including visits, referrals, caregiver demographics, equipment utilization , and caregiver and Veteran satisfaction. Develops implements and… more
    Veterans Affairs, Veterans Health Administration (01/31/25)
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  • RN-Community Care Coordinator

    Veterans Affairs, Veterans Health Administration (Sheridan, WY)
    …intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, ... health care to Veterans? Responsibilities The Community Care (CC) Coordinator Registered Nurse (RN) is responsible for executing a...Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days… more
    Veterans Affairs, Veterans Health Administration (02/01/25)
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  • Episode Assessment Coordinator /RN Home…

    PruittHealth (Norcross, GA)
    …appropriate data elements are included in the POC. + Review visit utilization for appropriateness as per care guidelines, best practices, and patient ... of the Director of Episode Assessment Coordination (DEAC), the Episode Assessment Coordinator (EAC) is responsible for prospective review of episode related… more
    PruittHealth (12/13/24)
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  • Critical Care Transfer Coordinator (RN)…

    Atlantic Health System (Florham Park, NJ)
    …plan, including transfer eligibility, level of care, resource prioritization & utilization , timely acceptance, and appropriate priority and mode of transport. + ... as assigned. + Accurately completes and transmits all required documentation per policies/procedures. + Generates regular and on demand reports as assigned.… more
    Atlantic Health System (12/04/24)
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  • Intake Coordinator - Rehabilitation - Part…

    ProMedica Health System (Toledo, OH)
    …years clinical experience in a patient care setting. Previous experience with utilization review , marketing, care transitions, customer service, and/or inpatient ... The Transition Coordinator is responsible for managing referrals and coordinating...the Flower Rehab Center. This role involves medical record review and interaction with internal and external physicians, nursing,… more
    ProMedica Health System (02/02/25)
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  • Clinical Coordinator NP OR PA…

    Penn Medicine (Philadelphia, PA)
    …seeing more than 175,000 outpatient visits annually. + The APP Clinical Coordinator will be responsible for overseeing the day-to-day clinical operations in ... collaboration with Practice Leadership. The Clinical Coordinator will communicate new processes, assist with coverage plans for unexpected needs, and act as the… more
    Penn Medicine (01/30/25)
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  • RN Maternity Service Coordinator - Bexar…

    CVS Health (San Antonio, TX)
    …(Teams, Outlook, Word, Excel, etc.) **Preferred Qualifications** + Managed care or utilization review experience highly preferred + Experience with Postpartum ... **remote,** work from home, with field visits to members as needed and per contractual requirements. The RN Service Coordinator utilizes advanced clinical… more
    CVS Health (01/23/25)
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