- Munson Healthcare (Traverse City, MI)
- …families, interdisciplinary team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic ... for coverage and compliance issues. + Works closely with decision support personnel to review resource utilization data and trends to identify outliers… more
- BayCare Health System (Clearwater, FL)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding ... services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote...and compassionate team. **The Utilization Review Specialist Senior responsibilities… more
- Mount Sinai Health System (New York, NY)
- …Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The Utilization Review Specialist coordinates scheduling of all surgical/endoscopic ... **Job Description** ** Utilization Review Admission Specialist ...up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experience discrimination. + Inspiring and… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties ... Officer/Medical Director as appropriate. + Coordinates an interdisciplinary approach to support continuity of care. + Provides utilization management, transfer… more
- Truman Medical Centers (Kansas City, MO)
- …into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Specialist 101 Truman Medical Center **Job ... training, coaching and consulting to outside organizations. **Job Description** The Utilization Specialist will verify all financial and insurance information,… more
- Cleveland Clinic (Vero Beach, FL)
- …or visit. Some of the responsibilities of a Utilization Management Specialist include medical record review , providing clinical information to payers, UM ... May design and initiate special projects as supervised by the Team Manager. Utilization Management Specialist Join our team at Cleveland Clinic Indian River… 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: ... County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose....net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,… more
- CareFirst (Baltimore, MD)
- …Qualifications** **PURPOSE:** Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent ... and benefit coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist , will analyze clinical information,… more
- ManpowerGroup (Durham, NC)
- …are seeking highly organized and self-motivated candidates for a remote, non-clinical review specialist role. The successful candidate will primarily make ... client, the largest health care industry, is seeking a utilization management specialist to join their team....outbound calls to members and providers to review medication requests and provide decisions on prescription drug… more
- Motion Recruitment Partners (Durham, NC)
- Utilization Management Specialist Durham, NC **100% Remote** Contract $17/hr - $17/hr Our client, a nationally recognized and award-winning company in the health ... insurance vertical, has a contract opening for a Utilization Management Specialist . They have over 4...or members to obtain the medical information for the review . * Identifies and refers organization determinations that require… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing… more
- LifePoint Health (Danville, VA)
- …degree preferred). Additional requirements include: . American Heart Association Basic Life Support . Experience in Utilization Review preferred . ... *Registered Nurse, RN - Utilization Review Case Manager* Job Type:Full...of those we serve.** *Connect with our RN recruiting specialist * Not ready to complete an application, or have… more
- University of Michigan (Ann Arbor, MI)
- Utilization Rev Appeals Spec Apply Now **Job Summary** **Why Join Michigan Medicine's Hospital Billing Audits & Appeals (HBAA) Department?** The Audit and Appeals ... Specialist has a strong knowledge of medical appeal and...Registration, MiVisit Business services, clinics and ancillary departments. + Review patient medical records and utilize clinical and regulatory… more
- Holcim US (Houston, TX)
- Carbon Capture Utilization Storage Integration Manager Requisition ID: 9456 Location: Houston, TX, US, 77547 Pay Type: Salary Travel Requirement: 31-40% **ARE YOU ... and Solutions & Products. Description: **ABOUT THE ROLE** The Carbon Capture Utilization and Storage Integration Manager will report to the Senior Project Manager… 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 of the UMRN program, conduct ongoing… more
- Health First (Viera, FL)
- *POSITION SUMMARY * The Case Management Support Specialist position is responsible for providing Quality/No Harm, Customer Experience, and Stewardship by ... problem-solving skills. *PRIMARY ACCOUNTABILITIES * 1. Gathers information from social workers, utilization review nurses, case managers, or patients to assist… more
- Xerox (Lincoln, RI)
- …implementation, the Supplier will collaborate with the Client on a continual basis to review the Client Printer Support Specialist job duties and provide ... Supplier's Client location(s) with a focus on maximizing uptime, utilization and user satisfaction while minimizing costs. They will... review and validation. + The Client Printer Support Specialist will work closely with our… more
- New Jersey Institute of Technology (Newark, NJ)
- Title: ERP Support Specialist Department: NJTPA Reports To: Director, Information Technology, NJTPA Position Type: Staff Position Summary: Under the direction of ... the Director of Information Technology, the ERP Support Specialist provides technical support in advancing NJTPA's enterprise resource planning (ERP)… more
- Integra Partners (Troy, MI)
- …do whatever it takes to get things done. PREFERRED SKILLS: + Certification in Utilization Review or Case Management + Experience with health insurance operations ... our Operations Training & Development team as an Operations UM Training Specialist , specializing in Utilization Management (UM) processes. The ideal candidate… more
- Commonwealth of Pennsylvania (PA)
- …calls, personal visits, and review of treatment progress reports; conduct utilization review . Orient clients to the program, policies, procedures, and ... Drug & Alcohol Case Management Specialist (Local Government) - Luzerne County D&A Print...clients or discharge planning via telephone, personal visits, or review of treatment progress reports; conducting utilization … more