• Physician Advisor (MD/DO)

    Munson Healthcare (Traverse City, MI)
    …and advise on justification for continued stay, medical necessity and utilization management + Participates in physician education and outreach efforts. + ... of Physician Advisors ( ACPA), American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP), or American Physician Leaders in Case… more
    Munson Healthcare (10/16/24)
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  • Utilization Review Physician Full…

    Hackensack Meridian Health (Hackensack, NJ)
    **Overview** **The Utilization Review Physician collaborates with the healthcare team in the** **management and resolution of activities that assure the ... patient status determinations - OBS vs. Inpatient** **c. Liaison to the Medical Staff supporting Utilization Management Committee processes** **d. Hospital Based… more
    Hackensack Meridian Health (11/02/24)
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  • Physician Utilization Review…

    Hackensack Meridian Health (Hackensack, NJ)
    …patient status determinations - OBS vs. Inpatient c. Liaison to the Medical Staff supporting Utilization Management Committee processes d. Hospital Based ... leadership to support, and provide assistance and support in overall medical management effectiveness, benchmarked utilization and cost management (UM)… more
    Hackensack Meridian Health (08/19/24)
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  • Medical Director: Documentation…

    Trinity Health (Boise, ID)
    …Saint Alphonsus is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This position will be ... Ability to work with Trinity Health experts in managing and developing medical utilization programs and documentation initiatives. **Work Experience** **Job… more
    Trinity Health (10/14/24)
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  • Utilization Management RN (Relief) - Case…

    Stanford Health Care (Palo Alto, CA)
    …days onsite in Palo Alto) **What you will do** + Perform timely comprehensive utilization reviews on patient medical records to determine the appropriate level ... with regulatory standards and achieve organizational goals. + Consult with the Physician Advisor to discuss complex cases, medical necessity, and strategies… more
    Stanford Health Care (10/23/24)
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  • Medical Director of Utilization

    Henry Ford Health System (Detroit, MI)
    …. + Previous experience as Director of Utilization Review or Physician Advisor preferred. CERTIFICATIONS/LICENSURES REQUIRED: + Michigan Medical license + ... The Medical Director of Utilization Review is...a timely manner 9. Code 44s - UM committee physician concurrent statement. CMS Conditions of Participation 10. Lead… more
    Henry Ford Health System (11/06/24)
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  • Utilization Mgmt II - Transfer…

    Sharp HealthCare (San Diego, CA)
    …other members of the health care team as well as the respective medical groups to facilitate the utilization management process.Identify and refers situations ... Manager, Physician Advisor, as appropriate.Participate in system or site-level utilization review activities and projects as needed.Maintain a log and report of… more
    Sharp HealthCare (09/28/24)
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  • Utilization Review RN

    Billings Clinic (Billings, MT)
    …cases do not meet payer criteria or OBS ≥ 24 hours Communicate with attending physician for OBS patients meeting medical necessity for inpatient level of care to ... a difference here. About Us Billings Clinic is a community-owned, not-for-profit, Physician -led health system based in Billings with more than 4,700 employees,… more
    Billings Clinic (11/05/24)
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  • Per Diem RN - Utilization Management…

    Sharp HealthCare (San Diego, CA)
    …with other members of the health care team as well as the respective medical groups to facilitate the utilization management process. Identify and refers ... Management (ICM) team the Per Diem RN (Adv CN)-Unit A4 position supports utilization review functions to ensure appropriate patient status before the patient is… more
    Sharp HealthCare (11/02/24)
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  • Utilization Review Nurse Supervisor II

    The County of Los Angeles (Los Angeles, CA)
    … direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one ... hospitals are training sites for physicians completing their Graduate Medical Education in nearly every medical specialty...utilization review standard. Under the direction of a physician member of the Utilization Review Committee,… more
    The County of Los Angeles (09/30/24)
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  • Utilization Review Specialist - PRN

    Munson Healthcare (Traverse City, MI)
    …colleagues and hospital associates at information meetings. + May represent Utilization Management on various committees, professional organizations, physician ... based on documented condition plan of treatment and care. + Supports physician decision-making by coaching on appropriateness of inpatient or observation status. +… more
    Munson Healthcare (11/09/24)
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  • LPN Utilization Mgmt Reviewer

    Guthrie (Binghamton, NY)
    …coding, medical record or chart auditing, and experience in utilization management processes preferred. Knowledge of computer applications (such as Microsoft ... LPN - Utilization Management (Days) Full Time Position Summary: The...process; coordinates as necessary with the hospital Business Office, physician offices, Care Coordination, Medical Director and… more
    Guthrie (09/11/24)
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  • RN Utilization Manager - Rex Case…

    UNC Health Care (Raleigh, NC)
    …the Utilization Manager is responsible for revenue protection by reconciling physician orders, bed billing type, and medical necessity. This may include ... Advisor as necessary to resolve barriers through appropriate administrative and medical channels. 4. Utilization Outcomes Management - Monitors and guides… more
    UNC Health Care (11/07/24)
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  • Market Director Utilization Management

    Catholic Health Initiatives (Lexington, KY)
    …causes related to physician performance and facilitates educational training for medical staff on issues related to utilization management. 8. Implements ... Joseph Health supports 5000 active employees 8 hospitals specialty clinics and a Medical Group with more than 200 locations across Central and Eastern KY.… more
    Catholic Health Initiatives (09/19/24)
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  • Medical Director- Utilization

    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
    AnMed Health (10/22/24)
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  • Utilization Review Nurse Coordinator (40…

    State of Connecticut, Department of Administrative Services (East Hartford, CT)
    Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 241106-5613FP-001 Location East Hartford, CT Date Opened 11/7/2024 12:00:00 AM Salary ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=) position, located… more
    State of Connecticut, Department of Administrative Services (11/07/24)
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  • Utilization Review Specialist, Behavioral…

    Sutter Health (Berkeley, CA)
    …to justify acute hospital admission, need for continued stay, and proper utilization of physician , nursing, and ancillary services. Responsible for concurrent ... clinical nursing staff and other departments regarding documentation required for utilization review activities and processes. Collaborate with medical , nursing… more
    Sutter Health (10/24/24)
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  • Care Coordinator, Utilization Management

    Hackensack Meridian Health (Holmdel, NJ)
    …insurance company, billing certifications, concurrent managed care denial appeals and retrospective medical record utilization reviews. + Obtains and evaluates ... healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for… more
    Hackensack Meridian Health (10/24/24)
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  • Care Coordinator, Utilization Management

    Hackensack Meridian Health (Holmdel, NJ)
    …insurance company, billing certifications, concurrent managed care denial appeals and retrospective medical record utilization reviews. + Obtains and evaluates ... healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for… more
    Hackensack Meridian Health (08/15/24)
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  • SRS-Inpatient Case Manager II - Utilization

    Sharp HealthCare (San Diego, CA)
    …a comprehensive plan of care for each patient/family in collaboration with the physician , social worker and all members of the interdisciplinary team in the ... position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving care… more
    Sharp HealthCare (10/30/24)
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