- 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 (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
- 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
- Stanford Health Care (Palo Alto, CA)
- …Stanford Health Care (Remote) **What you will do** + Perform timely comprehensive utilization reviews on patient medical records to determine the appropriate ... with regulatory standards and achieve organizational goals. + Consult with the Physician Advisor to discuss complex cases, medical necessity, and strategies… more
- 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
- 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 (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
- 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
- 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
- UNC Health Care (Chapel Hill, 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
- Beth Israel Lahey Health (Burlington, MA)
- …amounts at any time. **Job Description:** In conjunction with the admitting/attending physician , the Utilization Review RN assists in determining the appropriate ... level of care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria… more
- 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
- 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
- Truman Medical Centers (Kansas City, MO)
- …log into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Specialist Team Lead 101 Truman Medical Center ... safety net healthcare system for Jackson County/Kansas City. We are an academic medical center, serving as the primary teaching institution for the UMKC Schools of… more
- 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
- 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 (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
- 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
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: This Utilization Review Denials Review Unit (DRU) 3 Team Lead will assist the Director of Utilization Review and the Associate Director of ... DRU 3 Team Lead writes appeal letters using UR medical directors and the medical team for...required for interface and collaboration with leadership, colleagues, providers, Physician Advisors, regulatory agencies, and other health care related… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …and communicate potential or identified concerns to the treatment team, Director of Utilization Management, and the Medical Director. + Review charts at ... continued treatment in inpatient level of care. Referral of cases with questionable medical necessity to Physician Advisor for determination. + Review clinical… more