- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- … Utilization Review Clinician PAY RANGE: $31.00-$49.24 PER HOUR REPORTS TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as member of ... monitor and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician maintains knowledge of, participates in further… more
- Desert Parkway Behavioral Healthcare Hospital (Las Vegas, NV)
- …Discharges to ensure that all days are authorized and identify denied days, coordinate with Director of Utilization Review and add to Denial Tracker when ... the insurance authorizations. Daily Discharges At the direction of the UR Director , retrieves required documentation from the patient's medical record per EMR for… more
- Ascension Health (Kalamazoo, MI)
- …**Additional Preferences** There will be a dual focus on case management and utilization review in this position + Case Management experience - Strongly ... preferred + Utilization Review experience - Strongly preferred **Why Join Our Team** Ascension Michigan operates 16 hospitals and more than 300 related… more
- AnMed Health (Anderson, SC)
- The Utilization Review Medical Director supports operations and direction of the Care Coordination, Clinical Documentation, and Utilization Management ... consultation to the leadership and staff who perform the functions of Utilization Management (UM), Case Management (CM), Transition Planning/ Discharge Planning, and… more
- St. Luke's University Health Network (Allentown, PA)
- …registrations and/or physician queries + Serves as liaison between Physician Advisor/Medical Director , Finance, Utilization Review Department and CDCI. ... of cases lost with feedback to respective departments + Conduct concurrent review with utilization review department for post op surgical cases with… more
- UTMB Health (Friendswood, TX)
- …trends of inappropriate resource utilization to Director and/or Assistant Director of Utilization Review /Case Management. + Maintains a documentation ... optimal quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical knowledge,… more
- BrightSpring Health Services (Dunbar, WV)
- …days of death and submit to State Health Services Director and Assigned Director , Clinical Practice* Review utilization report at least monthly to ensure ... are coordinated with behavioral and programmatic staff in partnership with the Executive Director . The Director of Nursing is accountable for overseeing the… more
- Trinity Health (Boise, ID)
- …level reviews for patients not meeting inpatient criteria. C. Participates in local Utilization Review Committee and be a member of appropriate committees and ... is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This...accurate reporting of bed status. F. Assist case managers, utilization review nurses and social workers to… more
- CareFirst (Baltimore, MD)
- …detail can be shared during the interview process. Plans, organizes, and manages utilization review programs. Directs the utilization of referral services. ... Upon Hire Required. **Experience:** 8 years' Experience in a clinical and utilization review role. 3 years Management experience. **Preferred Qualifications:** +… more
- Ascension Health (Nashville, TN)
- …initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully insured clients to ... market. Must be located within TN market. We're looking for an experienced Director of Utilization Management to join our team! In this pivotal role, you'll lead… more
- Prime Healthcare (Ontario, CA)
- …Clinical Utilization Management (UM) provides comprehensive oversight of the Utilization Review process for the self-insured Employee Health Plans, according ... needs. + Provides strategic leadership, development, and supervision to utilization review department, provides interprofessional collaboration with… more
- Ascension Health (Tulsa, OK)
- …initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for all self-funded and fully insured clients to ... professional licensure at time of hire. **Additional Preferences** + Strong Utilization Review experience + Exceptional communication skills + Leadership… more
- Prime Healthcare (Inglewood, CA)
- …to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Assesses ... credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189094/ director -of-case-management utilization -management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityCentinela Hospital… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …to the treatment team, Director of Utilization Management, and the Medical Director . + Review charts at identified review points and attend treatment ... benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and promoting optimal… more
- Behavioral Center of Michigan (Warren, MI)
- Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination, implementation and reporting of complex ... and supports the operations of Samaritan Behavioral Center. The Utilization Review Coordinator reviews the patient's chart...tasks requested by the UR Manager, CEO or Medical Director to meet the needs of the Center. Perform… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more
- Ascension Health (Baltimore, MD)
- …salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes ... functions for assigned sites. + Collaborate with the director to develop and implement quality review ...review programs and key performance indicators for all utilization review activities. + Interact with medical,… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring ... reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well… more
- Community Health Systems (Franklin, TN)
- …appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for ... documentation from the physician(s). + Escalates cases to the Utilization Review Manager and/or Physician Advisor if...part of the application or hiring process, contact the director of Human Resources at the facility to which… more
- Community Health Systems (Franklin, TN)
- …and efficiency of medical services and procedures in a Behavioral Health setting. Utilization review is the assessment for medical necessity, both for admission ... documentation from the physician(s). + Escalates cases to the Utilization Review Manager and/or Physician Advisor if...part of the application or hiring process, contact the director of Human Resources at the facility to which… more
Related Job Searches:
Director,
Director Utilization,
Director Utilization Review Management,
Director Utilization Review Mgmt,
Medical Director Utilization Review,
Nurse Director Utilization Review,
Review,
Utilization,
Utilization Review