- Marion County (Salem, OR)
- …initiate authorization process for requests for Long-Term Psychiatric Care.Ensure accuracy of utilization data of those admitted to the Oregon State Hospital and ... Ensure residential capacity, track referrals, placements, placement/discharge dates, and utilization data is being tracked by Choice team. Provide clinical… more
- BayCare Health System (Cotton Plant, AR)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding ... and compassionate team. **The Utilization Review Specialist Senior responsibilities...Emergency Nursing RN. **Certifications and Licensures:** + Required RN ( Registered Nurse) + Preferred ACM (Case Management) + Preferred… more
- HonorHealth (Scottsdale, AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… 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 Type: ... 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 Washington (Seattle, WA)
- …partial/variable involvement with Harborview's Emergency Department. The Utilization Management Specialist RN2 is responsible for the ongoing review of a ... benefits for this position, click here (https://hr.uw.edu/benefits/wp-content/uploads/sites/3/2018/02/benefits-summary-classified-staff-greater-than-half-time-20220908\_a11y.pdf) . RN2, Utilization Management Specialist . This is a hybrid… more
- New York State Civil Service (Wallkill, NY)
- …years of post-licensure clinical nursing experience of which one year was in utilization review and/or discharge planning. Substitution: a bachelor's degree in ... Yes Agency Corrections and Community Supervision, Department of Title Registered Nurse 2 - Utilization (NY HELPS)...to verify your identity. Name Katrina Truax, Human Resources Specialist 1 Telephone ### Fax ### Email Address ###@doccs.ny.gov… more
- MyFlorida (Chattahoochee, FL)
- Registered Nurse Specialist F/C - 67072414 APD/ DDDP CHATTAHOOCHEE, FL Date: Jul 16, 2024 Location: CHATTAHOOCHEE, FL, US, 32324 The State Personnel System is an ... 833220 Agency: Agency for Persons with Disabilities Working Title: Registered Nurse Specialist F/C - 67072414 APD/...as a member of the DDDP Behavior Analysis Local Review Committee, Support Planning Committee, and treatment team. Performs… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST OPS - 60955422 Date: Jun 30, 2024 Location: MACCLENNY, FL, US, 32063 The State Personnel System is an E-Verify employer. For more ... . Requisition No: 772103 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST OPS - 60955422 Position Number: 60955422… more
- MyFlorida (Tallahassee, FL)
- OPERATIONS REVIEW SPECIALIST - 60047159 - ESS Policy & Programs 1 Date: Jul 11, 2024 Location: TALLAHASSEE, FL, US, 32303 TALLAHASSEE, FL, US, 32311 TALLAHASSEE, ... . Requisition No: 833090 Agency: Children and Families Working Title: OPERATIONS REVIEW SPECIALIST - 60047159 - ESS Policy & Programs 1… more
- Katmai (Usaf Academy, CO)
- …for inpatient/outpatient precertification. **ESSENTIAL DUTIES &** **RESPONSIBILITIES** + Review precertification requests for medical necessity, referring to the ... Medical Director those that require additional expertise. + Review clinical information for concurrent reviews. + As part...Minimum of two (2) years of prior experience in Utilization Management. + Must possess a current, active, full,… more
- Sanford Health (MN)
- …- $28.00 **Department Details** Opportunity to work remote **Job Summary** Monitors the utilization of resources, risk management and quality of care for patients in ... hospitalization to ascertain medical necessity and appropriateness. Assists with retrospective review of specified charts as required. Ability to interact on an… more
- MyFlorida (Tallahassee, FL)
- OPERATIONS REVIEW SPECIALIST - 79019780 Date: Jul 15, 2024 Location: TALLAHASSEE, FL, US, 32399 The State Personnel System is an E-Verify employer. For more ... Requisition No: 833020 Agency: Business and Professional Regulations Working Title: OPERATIONS REVIEW SPECIALIST - 79019780 Pay Plan: Career Service Position… more
- Trinity Health (Livonia, MI)
- …**Description:** Trinity Health at Home is seeking an experienced RN Clinical Quality Review Specialist - REMOTE **Trinity Health at Home is seeking an ... experienced RN Clinical Quality Review Specialist - REMOTE** **Position Summary** The...accurate documentation and plan of care development including visit utilization targets and identification of hospitalization risk to produce… more
- LA Care Health Plan (Los Angeles, CA)
- …and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Enhanced Care Management Clinical Specialist II Job Category: Clinical Department: Care Management...Light Additional Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM),… more
- SSM Health (St. Louis, MO)
- …pharmaceutical care in their specialty practice area which may include: review and evaluation of patient drug/medical history, providing drug therapy recommendations ... evaluating medical literature, rounding with other healthcare providers, drug utilization reviews, patient counseling and order entry/verification/dispensing. + Plans,… more
- Sharp HealthCare (San Diego, CA)
- …Patient Safety (CPPS) - Certification Board for Professionals in Patient Safety; California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's ... **What You Will Do** The purpose of the Sr. Performance Improvement Specialist is to improve clinical outcomes including responsibilities relating to leading teams… more
- Sharp HealthCare (San Diego, CA)
- …Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; ServSafe Food ... excellent evidence-based quality of services, and assuring timely and accurate quality review in compliance with the hospice and palliative care quality/safety plan.… more
- Henry Ford Health System (Bingham Farms, MI)
- …of pharmacy services, decrease waste, and rework in the region, and improve drug utilization . The Pharmacy Specialist will be instrumental in guiding the further ... GENERAL SUMMARY: The Pharmacy Specialist provides oversight and leadership for appropriate drug...provided by the primary care team. He/she works with utilization management reports, corporate data stores, and information services… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …scenarios and utilization are entered to support data capture and utilization review . + Provides support to center director, associate director(s) and ... **38186BR** **Extended Job Title:** Simulation Center Specialist (TECHS/Alberta) **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:**… more
- Trinity Health (Farmington Hills, MI)
- …rejection, denial and appeal activities with Ministry Organization (MO) based Utilization Review /Case Management departments; + Reviews and understands ... utilization review and coverage guidelines for multiple payers; + Identifies...and reviews findings with all levels of Payment Resolution Specialist for further review . Serve as a… more
