- 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 ... notes are documented, and the authorization detail is set up in Case Management . The information is subsequently verified in the payor websites where applicable. … 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
- 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. ... Conducts reviews of cases lost with feedback to respective departments + Conduct concurrent review with utilization review department for post op surgical… more
- 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
- 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
- Minnesota State (Bemidji, MN)
- …on the specified Closing Date (if designated).** **Working Title:** State University Mgmt Officer - Director of Business Services **Institution:** Bemidji State ... University **Classification Title:** State University Mgmt Officer **Bargaining Unit / Union:** 220: Managerial Plan...**(NTC)** invite applicants to join our team as the ** Director of Business Services** . The ** Director … more
- Elevance Health (Los Angeles, CA)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education and ... The Med Mgmt Nurse CA is responsible for review...treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do not… more
- Elevance Health (Los Angeles, CA)
- …or equivalent. Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted RN license ... more junior Clinicians. Approval decisions may be subject to review by more senior nurses or Medical Director...initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes.… more
- Elevance Health (Norfolk, VA)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education and ... **Medical Management Nurse** **Federal Employee Program - FEP** ,...is medically necessary and provides consultation to the Medical Director on cases that are unclear or do not… 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
- 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
- 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
Related Job Searches:
Director,
Director Utilization,
Director Utilization Review,
Mgmt,
Review,
Utilization,
Utilization Review