• Blanchard Valley Hospital (Findlay, OH)
    PURPOSE OF THIS POSITION The primary purpose of the Professional Coding Integrity Specialist (PCIS) is to review , enter and/or modify charges as appropriate, ... charge/modifier assignments, for designated clinical areas. JOB DUTIES/RESPONSIBILITIES Duty 1: Review , enter and/or modify charge on encounters to ensure accurate… more
    JobGet (07/01/24)
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  • Blanchard Valley Hospital (Findlay, OH)
    …investigational or potential compliance risks. Duty 7: Work with Coding Claims Resolution Specialist (CCRS) to review denial trends, whether coding related or ... auditor/educator when needed, coordinate staff schedules, payroll, completion of associate performance evaluations, recognition and reward, disciplinary follow up as… more
    JobGet (07/01/24)
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  • Associate Utilization Review

    Providence (WA)
    …retain the best people, we must empower them._** **Providence Health Plan is calling an Associate Utilization Review Specialist who will:** + Be ... the following clinical teams: + Prior-authorization (PA) + Concurrent Review (CCR) + SNF + Clinical Claims + Coordinate...+ Clinical Claims + Coordinate and execute the medical review and research functions required to support all teams… more
    Providence (06/26/24)
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  • Denials Specialist - Utilization

    BayCare Health System (Cotton Plant, AR)
    …of trust, dignity, respect, responsibility and clinical excellence. **The Denials Specialist - Utilization Review responsibilities include:** + Timely reviews ... and Experience:** + Required Associate Degree in Nursing and 4 years Utilization Review , Managed Care or Finance OR Bachelors Degree in Nursing and… more
    BayCare Health System (06/28/24)
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  • RN Utilization Review

    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
    HonorHealth (05/20/24)
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  • Utilization Review Specialist

    MetroHealth (Cleveland, OH)
    …**Responsible for communicating information to internal and external customers of the Utilization Review and Care Management Department. Follows up on inquiries ... from payors and provides the appropriate information to Utilization Review , providers, payors, and admitting. Upholds the mission, vision, values, and customer… more
    MetroHealth (06/15/24)
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  • Utilization Management Nurse…

    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
    LA Care Health Plan (05/07/24)
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  • Clinical Quality Review Specialist

    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
    Trinity Health (06/26/24)
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  • Respiratory Specialist

    Bassett Healthcare (Little Falls, NY)
    …with the Medical Director of Respiratory Care Services, the Respiratory Specialist is responsible for assisting in the development, implementation, and ... administration of all policies and procedures. The Respiratory Care Specialist performs all roles and responsibilities of a Respiratory Therapist. The Respiratory… more
    Bassett Healthcare (06/14/24)
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  • HS Client Benefit Specialist

    Ventura County (Ventura, CA)
    HS Client Benefit Specialist Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4440930) Apply  HS Client Benefit Specialist Salary $44,512.49 ... and join Ventura County as a HS Client Benefit Specialist ! WHAT WE OFFER The County of Ventura offers...An educational incentive of 2.5% for completion of an associate 's degree, 3.5% for completion of a bachelor's degree,… more
    Ventura County (04/04/24)
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  • Registered Nurse - Accreditation and Quality…

    Veterans Affairs, Veterans Health Administration (Hines, IL)
    Summary The Accreditation and Quality (A&Q) Nurse Specialist demonstrates leadership in providing continuous readiness for accreditation and regulatory agency ... review and compliance (Joint Commission, Inspector General, Long Term...rewards package: VA Nurse Total Rewards The A&Q Nurse Specialist reports directly Chief of Quality. He/she is accountable… more
    Veterans Affairs, Veterans Health Administration (06/28/24)
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  • Administrative Services Specialist

    City of Asheville (Asheville, NC)
    …necessary to function effectively in the position. Performance Aptitudes: Data Utilization : Requires the ability to review , classify, categorize, prioritize, ... Administrative Services Specialist - Criminal Investigations Division Print (https://www.governmentjobs.com/careers/ashevillenc/jobs/newprint/4495241) Apply … more
    City of Asheville (05/06/24)
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  • Enhanced Care Management Clinical…

    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
    LA Care Health Plan (06/01/24)
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  • Site Procurement Specialist (Nuc)

    Entergy (Russellville, AR)
    …REQUIREMENTS** **Minimum education and experience required of the position** **Site Procurement Specialist I** : Associate 's degree in Supply Chain, Business, ... Site Procurement Specialist (Nuc) **Date:** Jun 6, 2024 **Location:** Russellville,...orders; understanding of the alternate buying channels and the utilization of central resources to fulfil orders; + Basic… more
    Entergy (05/09/24)
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  • Conservation Staff Specialist 2

    State of Nevada (NV)
    CONSERVATION STAFF SPECIALIST 2 APPROXIMATE ANNUAL SALARY - $60,635.52 to $90,180.72 PAY GRADE: 36 For more information on benefit and retirement programs, please ... This position is responsible for leadership and guidance of all Biomass Utilization and Forest Products programming which includes the coordination and oversight of… more
    State of Nevada (06/19/24)
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  • Clinical Simulation Specialist EMT

    HCA Healthcare (Richmond, VA)
    …growth, we encourage you to apply for our Division Clinical Simulation Specialist opening. We promptly review all applications. Highly qualified candidates ... **Description** **Introduction** Division Clinical Simulation Specialist Schedule: Full-Time (hourly) Monday-Friday, days only. EMT experience strongly preferred.… more
    HCA Healthcare (06/16/24)
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  • Admin Specialist Assoc Health

    University of Michigan (Ann Arbor, MI)
    …development. The UMHS market title for this position is Administrative Specialist Associate . **Mission Statement** Michigan Medicine improves the health ... Admin Specialist Assoc Health Apply Now **Summary** The Administrative...Coordinate timekeeping and payroll for CES nursing team: 2. Review , report, and maintain timekeeping and payroll records for… more
    University of Michigan (07/02/24)
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  • Clinical Simulation Specialist

    HCA Healthcare (Tampa, FL)
    …is important to you, we encourage you to apply for our Clinical Simulation Specialist opening. Our team will promptly review your application. Highly qualified ... our colleagues in their positions. Join our Team as a(an) Clinical Simulation Specialist and access programs to assist with every stage of your career. **Benefits**… more
    HCA Healthcare (06/22/24)
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  • Clinical Transition Specialist RN

    Carle (Urbana, IL)
    … issues in appropriate locations, including but not limited to: case management/ utilization review software and the multidisciplinary plan of care document ... Clinical Transition Specialist RN + Department: IP Clinical Case Mgmt...well and has what they need for success. Initial utilization review for emergency room patients being… more
    Carle (05/28/24)
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  • Coordination of Benefits Validation…

    LA Care Health Plan (Los Angeles, CA)
    …of benefits data, identifying discrepancies, and resolving issues to optimize benefit utilization and minimize costs. The COB Validation Specialist collaborates ... Coordination of Benefits Validation Specialist II Job Category: Administrative, HR, Business Professionals Department: Claims Integrity Location: Los Angeles, CA,… more
    LA Care Health Plan (06/28/24)
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