- Daiichi Sankyo, Inc. (Bernards, NJ)
- …pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science and ... areas centered around rare diseases and immune disorders.Summary: The Associate Director , Regional Marketing Conventions & Field Programs will be responsible for… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …lock. Conducts final coding listings review ; distributes final coding listings for medical review and approval. Drafts the final coding approval form and ... for assigned studies and escalates issues to the Associate Director of Medical Coding to gain resolution....clinical trial experience preferredMust have a strong understanding and utilization of medical terminology; experience in coding… more
- AnMed Health (Anderson, SC)
- The Utilization Review Medical Director supports operations and direction of the Care Coordination, Clinical Documentation, and Utilization ... Management programs at AnMed. The Medical Director ensures the program and associated physicians work collaboratively with and provide consultation to the… more
- St. Luke's University Health Network (Allentown, PA)
- …and/or physician queries + Serves as liaison between Physician Advisor/ Medical Director , Finance, Utilization Review Department and CDCI. PHYSICAL AND ... Conducts reviews of cases lost with feedback to respective departments + Conduct concurrent review with utilization review department for post op surgical… more
- Trinity Health (Boise, ID)
- …**Job Description:** Saint Alphonsus is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This position ... annually by the Saint Alphonsus Chief Clinical Officer. The Medical Director of Documentation and Utilization...patients not meeting inpatient criteria. C. Participates in local Utilization Review Committee and be a member… 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 ... located within TN market. We're looking for an experienced Director of Utilization Management to join our...consisting of a network of hospitals, affiliated joint ventures, medical practices, clinics and specialty facilities. Ascension is a… 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
- Prime Healthcare (Inglewood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189094/ director -of-case-management utilization ... Overview Centinela Hospital Medical Center has been serving the communities of...case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization … 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
- 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...all tasks requested by the UR Manager, CEO or Medical Director to meet the needs of… 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
- Hackensack Meridian Health (Belle Mead, NJ)
- …concerns to the treatment team, Director of Utilization Management, and the Medical Director . + Review charts at identified review points and ... resources and benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and promoting… more
- Martin's Point Health Care (Portland, ME)
- …requests (prior authorization, concurrent review , and retrospective review ) for medical necessity referring to Medical Director as needed for ... "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member...Utilize evidenced-based criteria, governmental policies, and internal guidelines for medical necessity reviews. + Manage the review … more
- Community Health Systems (Franklin, TN)
- …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...or to place in outpatient with observation services. + Review medical records for appropriate indicators of… more
- Ascension Health (Baltimore, MD)
- … review programs and key performance indicators for all utilization review activities. + Interact with medical , nursing, and executive leadership to ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
- Community Health Systems (Franklin, TN)
- … medical services and procedures in a Behavioral Health setting. Utilization review is the assessment for medical necessity, both for admission to the BHU ... documentation from the physician(s). + Escalates cases to the Utilization Review Manager and/or Physician Advisor if...medical staff hospital's to perform an internal secondary review . The UR Clinical Specialist may assist coordinating a… more
- Desert Parkway Behavioral Healthcare Hospital (Las Vegas, NV)
- …care issues with the Director of Clinical Services and Chief Medical Officer/ Medical Director as appropriate. + Coordinates an interdisciplinary ... of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …care issues with the Director of Clinical Services and Chief Medical Officer/ Medical Director as appropriate. + Coordinates an interdisciplinary ... of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness… more
- Stanford Health Care (Palo Alto, CA)
- …and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge planning. + ... Health Care (SHC)? - Recognized as a top Academic Medical Center globally! - Ranked No. 10 on the...leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care… more
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