- Community Health and Counseling Services (Bangor, ME)
- Insurance Verification and Utilization Review Specialist - Health Services Job Type(s):Full-Time Location(s):Bangor, Maine Education:Associates Degree - ... staff, patients, family members, facilities and physician. Responsible for utilization management of services, verifying authorization of services throughout… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print...give will determine your eligibility and is subject to verification at any time. b. You must be at ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,161.60 - $176,872.80 Annually… more
- Kelsey-Seybold Clinic (Houston, TX)
- **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews, benefit verification , and applying criteria to ... authorization prior to services being rendered for members. The Utilization Review Specialist (LVN) serves as a... of denial letters based on Texas Department of Insurance (TDI) and or Centers for Medicare and Medicaid… more
- Baptist Memorial (Jackson, MS)
- Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed ... by utilization review standards. The UR Nurse works with providers, insurance companies and patients to ensure cost-effective and appropriate care. Areas of… more
- Ascension Health (Wamego, KS)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Martin's Point Health Care (Portland, ME)
- …as a "Great Place to Work" since 2015. Position Summary The Associate Utilization Review Assistant is responsible for providing non-clinical support to the ... Utilization Management (UM) Team. This role supports the operation...UM team through internal and external customer service. eligibility verification , data entry of authorizations/organization determinations (OD), ensuring completeness… 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 ... Provide strategic direction and oversight of the day-to-day operations of utilization management function within the insurance plan. + Ensure… more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Insurance Verification Specialist 2 provides patients, physicians and internal hospital personnel with insurance benefit information. ... + Calculates accurate patient financial responsibility. + Communicates timely with Utilization Review , and partners effectively with physician and facility… more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Insurance Verification Specialist 1, under general supervision, provides patients, physicians and internal hospital personnel with ... needs. Calculates accurate patient financial responsibility. Communicates timely with Utilization Review , and collaborates effectively with physician and… more
- Novant Health (Winston Salem, NC)
- Job Summary Responsible for ensuring appropriate insurance verification , ie correct coverage, applicable benefits, and coordination of benefits. Responsible for ... with other hospital departments including admitting/registration, financial counseling, and utilization review . Communicate with provider offices (ie surgery… more
- The County of Los Angeles (Los Angeles, CA)
- …+ Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT INFORMATION: ... the work of staff, and evaluating employee performance. For this examination, Utilization Review is defined as provides technical and administrative direction… more
- Providence (Santa Monica, CA)
- …and other relevant professionals that measurably improve performance. + Create, and analyze utilization review metrics, maintained in the form of a dashboard, ... issues. + Responsible for final review of all Medicare 1 Day Stays, ie, verification of clinical review and for presenting monthly report on Medicare 1 day… more
- Mohawk Valley Health System (Utica, NY)
- …specialist regarding correct level of care and reimbursement. Apply knowledge of utilization review , discharge planning, patient status changes, length of stay, ... barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance with regulatory requirements, hospitals objectives,… more
- 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 ... Requirements Light Additional Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), … more
- Ventura County (Ventura, CA)
- …of up to $23,530 annually to offset the purchase of medical, dental, and/or vision insurance for you and your dependents. + Employee only - $502 per biweekly pay ... Benefits - Tuition Reimbursement, Disability Plans, Employee Assistance Program, Life Insurance , Wellness Program. OUR COUNTY AND COMMUNITY Ventura County is located… more
- The County of Los Angeles (Los Angeles, CA)
- …NICU, Burn ICU), Oncology, Parenteral Nutrition, Ambulatory Care, Drug Utilization Review , Anti-Coagulation, Purchasing Consultant, Drug Information, ... by assisting in the establishment of criteria for cost effectiveness/control utilization use, process indicators, and monitoring parameters; conducts evaluations to… more
- UIC Government Services and the Bowhead Family of Companies (Bremerton, WA)
- …and functionality of industrial facilities and infrastructure projects. Prepare and review draft scope of work documents and other related planning documents. ... considerations, and base support requirements into project plans. + **Space Utilization :** Optimize space utilization across facilities to enhance operational… more
- Select Medical (Newport News, VA)
- …and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan ... a patient-specific, safe and timely discharge plan. + Performing verification of utilization criteria reviews. + Building... insurance benefit coverage for the patient. Reviews insurance verification forms to minimize risk. +… more
- MetroLink (Los Angeles, CA)
- …will be forwarded to the hiring authority for consideration. The first review of applications begins January 13, 2025. Interested applicants are encouraged to ... of responsibilities. + Ensure compliance with applicable Authority and department policies. Review contracts and grant documents prior to setting up award/ project… more
- Rochester Precision Optics (West Henrietta, NY)
- …manufacturing processes within the facility; creates project plans, performs utilization studies, identifies capacity needs and constraints, and makes ... by analyzing equipment layouts, workflow, assembly methods, and work force utilization . Determines parts and tools needed to achieve manufacturing goals according… more