- The Laurels of Huber Heights (Dayton, OH)
- …interdisciplinary team Assesses resident through physical assessment, interview and chart review . Discusses resident care needs with care givers, including ... physician , nursing, social services, therapy, dietary, and activity staff....PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator… more
- The Laurels of Salisbury (Salisbury, NC)
- …time frames. Assesses resident through physical assessment, interview and chart review . Discusses resident care needs with care givers, including physician ... schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator Remains current with the… more
- Alameda Health System (Oakland, CA)
- …for patients, improve the quality of patient care and maximize the efficient utilization of physician and hospital resources. Report to departmental leadership ... Emergency Medicine Physician + Oakland, CA + Highland General Hospital...with EM Chair and or Vice Chair annually to review yearly goals and expectations. **MINIMUM QUALIFICATIONS** : Education:… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …bundling edits, and recommend action steps regarding code configuration issues, annual utilization and review analysis. + Maintain current knowledge of coding ... procedure and diagnosis codes, and support business decisions regarding utilization management activities and guidelines. + Support medical policy development… more
- Stanford Health Care (Palo Alto, CA)
- …provides clinical direction and education, works closely with operational and physician leaders, and has oversight of hiring, termination, and professional growth ... Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), or the Physician Assistant (PA) Job Description approved by the Interdisciplinary Practice… more
- Valero (San Antonio, TX)
- …industry experience and proficiency with Disability Management (STD/LTD), Workers' Compensation, Utilization Review , and/or nurse case management preferred. Need ... internal partners throughout the claim process. * Coordinates with third-party medical review vendors for complex or extended claims. * Evaluates claims for… more
- Stanford Health Care (Palo Alto, CA)
- …Provides clinical direction and education, works closely with operational and physician leaders, and has oversight of hiring, termination, and professional growth ... Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), or the Physician Assistant (PA) Job Description approved by the Interdisciplinary Practice… more
- Stanford Health Care (Palo Alto, CA)
- …planning, hiring and termination, and working closely with operational and physician leaders on a wide variety of organizational initiatives. **Locations** Stanford ... and adherence to policy through practice analysis and case review of APPs with physicians. + Investigates and responds...on evidence by using research based knowledge or research utilization methods to identify and implement innovations in patient… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...patients who were readmitted within thirty days. Documents over utilization of resources and services. + All Medicare cases… more
- Stanford Health Care (Palo Alto, CA)
- …+ Uses independent judgement to assess, identify, and prioritize clinical information to physician , NP, PA and other clinicians for patients who are being evaluated ... care as defined by the research protocol with the physician and other health care professionals and research team...site visits and study close-outs; and collaborates on the review of documentation during protocol audits. + Develops protocol… more
- Battelle Memorial Institute (Fort Bragg, NC)
- …and current notes in the electronic medical records of all patients contacted for review by the managing physician + Routinely staff difficult cases with the ... will support positive programs for equal treatment of all staff and full utilization of all qualified employees at all levels within Battelle._ The above statements… more
- Stanford Health Care (Palo Alto, CA)
- …for changes in process and operations to include standardization and utilization of resources (supplies, equipment, services, people, etc.). The Category Manager ... of the SHC & LPCH Value Based Selection group, which is a physician led multi-specialty committee that evaluates all requests for new products and technology.… more
- Katmai (Usaf Academy, CO)
- …procedures, treatments and medications are administered in accordance with (IAW) physician orders, sound nursing judgment and applicable guidelines. + Accurately ... all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. Adhere… more
- Stanford Health Care (Palo Alto, CA)
- …budgets, and provide progress status reports to key stakeholders, which may include physician leaders and executive leadership. + Review and assess performance ... practice based on evidence by using research based knowledge or research utilization methods to identify and implement innovations in patient care and/or… more
- Stanford Health Care (Menlo Park, CA)
- …which includes strategic planning, financial performance management, resource utilization , contract administration, operational metrics, lease administration, and ... the dynamics of these individuals. + Work with and drive change across physician groups that balance clinical, academic and research interests. + Project Management… more
- Hackensack Meridian Health (Hackensack, NJ)
- The Utilization Review Physician collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical ... Hackensack University Medical Center. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… 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
- CommonSpirit Health (Phoenix, AZ)
- …by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. + Physician Advisor Sub-specialty Certification ... This role will be an expert on matters regarding physician practice patterns, over and under- utilization of...by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. **Required… more
- Intermountain Health (Trenton, NJ)
- …geographic regions as assigned. Physician shall work in partnership with the utilization review committee to ensure procedures are in place to follow all ... Appeals Unit ("CAU"). + Attend System Utilization Review ("UR") Committee and provide Regional Physician ...IHCHS meetings as needed. + Add Utilization Review shifts as directed by System Physician … more
- Trinity Health (Des Moines, IA)
- …Process Improvement. Physician Relationships. Hospital Management and operations. Utilization review / physician advisor Graduate Medical Education ... a matrixed relationship for centralized medical staff functions such as quality, safety and utilization review and to the RHM President and other members of the… more
