- UTMB Health (Friendswood, TX)
- …resource utilization to Director and/or Assistant Director of Utilization Review /Case Management . + Maintains a documentation system of all ... ensure optimal quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical… more
- Ascension Health (Nashville, TN)
- …the TN market. Must be located within TN market. We're looking for an experienced Director of Utilization Management to join our team! In this pivotal ... **Details** + **Department:** Utilization Management + **Schedule:** Monday -...Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully insured… more
- Trinity Health (Boise, ID)
- …of two years' experience in hospital based medicine with exposure to utilization management and documentation initiatives. 3. Demonstrated teamwork, performance ... MDDUE will work in a dyad partnership with the Director of Clinical Resource Management . This position...patients not meeting inpatient criteria. C. Participates in local Utilization Review Committee and be a member… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical ... Utilization Management (UM) provides comprehensive oversight of the Utilization Review process for the self-insured Employee Health Plans, according to… more
- AnMed Health (Anderson, SC)
- The Utilization Review Medical Director supports operations and direction of the Care Coordination, Clinical Documentation, and Utilization Management ... to the leadership and staff who perform the functions of Utilization Management (UM), Case Management (CM), Transition Planning/ Discharge Planning,… more
- Prime Healthcare (Inglewood, CA)
- …Provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... experience, education, 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)… more
- Community Health Systems (Franklin, TN)
- …experience in healthcare as a nurse required + 1-3 years work experience in Care Management or Utilization Review required + 1-2 years work experience as ... **Job Summary** The Manager of Utilization Review oversees a team of...supports and coordinates the various aspects of the hospital's utilization management program, denials and appeals activities.… more
- Behavioral Center of Michigan (Warren, MI)
- Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination, implementation and reporting of complex ... clinical data and supports the operations of Samaritan Behavioral Center. The Utilization Review Coordinator reviews the patient's chart and records clinical… 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
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr- CMC-Clear Lake Center - shift 3:00 PM-11:00 PM - Monday-Friday **Webster, Texas, United States** **New** Nursing & Care ... efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions,… more
- Stanford Health Care (Palo Alto, CA)
- …Skills and Abilities** + Knowledge of principles and best practices of case management , utilization review , social work, care coordination and discharge ... practice. Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation,… 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
- Ascension Health (Baltimore, MD)
- …and salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing ... functions for assigned sites. + Collaborate with the director to develop and implement quality review ...the areas of utilization criteria, appeal and review process, and case management system documentation.… more
- Lawrence General Hospital (Lawrence, MA)
- …overseeing day-to-day operations within the department with a specific focus on utilization review management . Responsible for establishing appropriate ... + Assists in overseeing secondary review process, utilization review management , audit and...measure outcomes and reports regularly to the manager and director of the department + Oversees activities of staff… more
- Community Health Systems (Franklin, TN)
- …clinics, imaging centers, cancer centers and ambulatory surgery centers. **Summary:** Utilization management is the analysis of the necessity, appropriateness, ... of medical services and procedures in the hospital setting. Utilization review is the assessment for medical...presenting after the call and documented in the case management system by the UR Review Specialist.… more
- Dignity Health (Mesa, AZ)
- …Director of Care Management , performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted… more
- 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 ... from your internet provider (non-satellite). + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical… more
- ERP International (Nellis AFB, NV)
- … Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); Comprehensive Accreditation ... No Call, No Weekends, No Holidays! **Job Specific Position Duties:** * Provides Utilization Management activities and functions by using MTF specific Quality… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …an interdisciplinary approach to support continuity of care. + Provides utilization management , transfer coordination, discharge planning, and issuance of ... The UR Specialist reviews and monitors patients' utilization of health care services with the goal...and quality of care. + Responsible for the proactive management of patients with the objective of improving quality… more
- 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 ... prioritize effectively and have critical thinking skills. Experience in case management or care coordination and telephonic care experience is preferred. +… more
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