• Utilization Review Tech I

    Prime Healthcare (Philadelphia, PA)
    …Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities The Utilization review tech ... review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone calls, data entry… more
    Prime Healthcare (12/31/24)
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  • Utilization Review Technician

    Prime Healthcare (Ontario, CA)
    …Responsibilities The Utilization review ... and health plans and scan all related correspondence to the respective EMR/ tracking tool. Utilization review tech will follow up on all denials while… more
    Prime Healthcare (01/24/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …+ Do you have experience with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US ... and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1... Tech Solutions:** US Tech Solutions is a… more
    US Tech Solutions (01/17/25)
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  • Utilization Review Nurse

    US Tech Solutions (Columbia, SC)
    …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... promote quality, cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and… more
    US Tech Solutions (12/20/24)
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  • Utilization Review Nurse

    US Tech Solutions (May, OK)
    …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF UTILIZATION ... policy, regulatory and accreditation guidelines. . Responsible for the review and evaluation of clinical information and documentation. ....in state of residence . Must have prior authorization utilization experience . Able to work in multiple IT… more
    US Tech Solutions (01/17/25)
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  • Utilization Tech I

    Prime Healthcare (Harlingen, TX)
    …Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities The Utilization review tech ... review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone calls, data entry… more
    Prime Healthcare (01/24/25)
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  • Utilization Tech I

    Prime Healthcare (Elgin, IL)
    …skillset, years of applicable experience, education, credentials and licensure. Responsibilities The Utilization Review Tech essentially works to coordinate ... and appeals process as part of the denial management initiatives. + Utilization review tech is responsible for coordinating phone calls, data entry,… more
    Prime Healthcare (12/27/24)
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  • Utilization Tech I

    Prime Healthcare (Aurora, IL)
    …skillset, years of applicable experience, education, credentials and licensure. Responsibilities The Utilization Review Tech essentially works to coordinate ... and appeals process as part of the denial management initiatives. + Utilization review tech is responsible for coordinating phone calls, data entry,… more
    Prime Healthcare (12/27/24)
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  • Utilization Tech I

    Prime Healthcare (Chicago, IL)
    …skillset, years of applicable experience, education, credentials and licensure. Responsibilities The Utilization Review Tech essentially works to coordinate ... and appeals process as part of the denial management initiatives. + Utilization review tech is responsible for coordinating phone calls, data entry,… more
    Prime Healthcare (12/27/24)
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  • Utilization Tech I

    Prime Healthcare (Joliet, IL)
    …skillset, years of applicable experience, education, credentials and licensure. Responsibilities The Utilization Review Tech essentially works to coordinate ... and appeals process as part of the denial management initiatives. + Utilization review tech is responsible for coordinating phone calls, data entry,… more
    Prime Healthcare (12/27/24)
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  • Utilization Tech I

    Prime Healthcare (Evanston, IL)
    …skillset, years of applicable experience, education, credentials and licensure. Responsibilities The Utilization Review Tech essentially works to coordinate ... and appeals process as part of the denial management initiatives. + Utilization review tech is responsible for coordinating phone calls, data entry,… more
    Prime Healthcare (12/27/24)
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  • Utilization Tech I

    Prime Healthcare (Chicago, IL)
    …skillset, years of applicable experience, education, credentials and licensure. Responsibilities The Utilization Review Tech essentially works to coordinate ... and appeals process as part of the denial management initiatives. + Utilization review tech is responsible for coordinating phone calls, data entry,… more
    Prime Healthcare (12/27/24)
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  • Clinical Review Management…

    St. Luke's Health System (Boise, ID)
    …for providing accurate and timely technical and administrative support across the utilization review process + Full Time + Benefits including hospital ... **Overview** At St. Luke's, our dedicated team of Clinical Review staff strives to build a positive, supportive, and inclusive culture that delivers exceptional… more
    St. Luke's Health System (01/15/25)
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  • Medical Director, Ventura County Health Care Plan

    Ventura County (Ventura, CA)
    …+ Experience with managed care. + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review systems and programs. + At ... Ventura has a diverse economic base from tourism to high- tech enterprises in beautifully planned communities, making the region...care + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review more
    Ventura County (11/14/24)
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  • Registered Nurse

    G-TECH Services, Inc. (Detroit, MI)
    …which may include acute patient care, discharge planning, case management, and utilization review , etc. Demonstrated clinical knowledge and experience relative ... Associate Degree or nursing diploma required, Triage, case management or utilization review experience, Expertise in the use of medical terminology, InterQual… more
    G-TECH Services, Inc. (12/26/24)
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  • Psychiatric Technician - IPU (Regular, Per…

    Ventura County (Ventura, CA)
    …that establish, expand, and maintain the pool of eligible service providers. + Utilization review : uses professional skills in quality management activities such ... Psychiatric Technician - IPU (Regular, Per Diem, Sr. Per...Health. NOTE: If appointed as a Per Diem Psych Tech , incumbent may be promoted to Per Diem Sr...as utilization review , monitoring and evaluation procedures, and… more
    Ventura County (01/23/25)
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  • Registered Nurse

    G-TECH Services, Inc. (Detroit, MI)
    …which may include acute patient care, discharge planning, case management, and utilization review with another insurance provider, etc. Demonstrates clinical ... specialized field such as NICU/OB/BH/Substance Abuse * * InterQual/MCG or other utilization review experience preferred Required Skills/Experience - The rest of… more
    G-TECH Services, Inc. (11/02/24)
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  • Licensed Independent Social Worker

    US Tech Solutions (Columbia, SC)
    …mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review /case management/clinical/or combination; 2 of the 4 ... mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review /case management/clinical/or combination; 2 of the 4… more
    US Tech Solutions (01/19/25)
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  • RN - Community Health

    Veterans Affairs, Veterans Health Administration (Marion, IL)
    …proper transfer of patient care, participate in collaborative case management planning, utilization review , discharge planning, and other related case management ... and/or other clinical care setting, Current community care and case management/ utilization review experience, proficiency with Microsoft Office products… more
    Veterans Affairs, Veterans Health Administration (01/17/25)
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  • Health Information Management Analyst II…

    University of Michigan (Ann Arbor, MI)
    …of General Counsel (OGC), the Office of Patient Relations and Clinical Risk, Utilization Review Management, and Revenue Cycle as requested or required. Process ... and provide support and customer services to all internal and external record review requesters. **What You'll Do** OPERATIONS + Provide medical records to the… more
    University of Michigan (01/12/25)
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