- Elliot Health System (Bedford, NH)
- …quality, risk management, utilization , infection control and resource utilization etc. Participates in multidisciplinary meetings to review ... more
- Intermountain Health (Las Vegas, NV)
- …health care organizations, which includes Medicare coverage criteria. **Job Profile:** Performs medical review activities pertaining to utilization review ... more
- Vanderbilt University Medical Center (Nashville, TN)
- …that the appropriate admission status is ordered. Conducts initial admission based on utilization review medical necessity criteria. Refers cases for ... more
- AnMed Health (Anderson, SC)
- The Utilization Review Medical Director supports operations and direction of the Care Coordination, Clinical Documentation, and Utilization Management ... more
- MD Anderson Cancer Center (Houston, TX)
- …clinical information as required to support medical necessity for services Ensures utilization review case closures are completed within 4 business days post ... more
- Independent Health (Buffalo, NY)
- …collaboration. **Overview** The Utilization Review Nurse (URN) performs clinical review to determine the medical necessity of requested services. The URN ... more
- Spectrum Billing Solutions (Skokie, IL)
- …and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for ... more
- Excellus BlueCross BlueShield (Rochester, NY)
- …II (in addition to Level I Qualifications) + Minimum 2-3 years of experience in medical management, utilization review and case management. + Knowledge of ... more
- Beth Israel Lahey Health (Burlington, MA)
- …a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center in Burlington Hospital ... more
- Prime Healthcare (Joliet, IL)
- …Medical Graduate, Dental Graduate, PA, or Nursing Graduate required. 2. Three years of Utilization Review experience as a Medical Review Coordinator - ... more
- ManpowerGroup (Columbia, SC)
- …to effectively communicate with members and healthcare providers. **Key Responsibilities** ✔ ** Medical Review & Utilization Management (80%)** + Perform ... more
- Insight Global (Long Beach, CA)
- …role within the healthcare industry - Care Review , Care Coordinator, Medical Assistant, Patient Services, Utilization Review , Authorization, Eligibility, ... more
- The Cigna Group (Bloomfield, CT)
- …by a supervisor in Utilization Management. Handles moderately complex medical review , utilization review , credentialing/re-credentialing, quality ... more
- SUNY Upstate Medical University (Syracuse, NY)
- …patients, maintaining accurate attendance and therapy records. Interfaces with nursing, medical staff, utilization review social services, discharge ... more
- Public Storage (Plano, TX)
- …+ Oversee reporting of claims and compliance with state filing requirements + Oversee medical utilization + Review and analyze all claims; identify claims ... more
- Molina Healthcare (Kenosha, WI)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two ... more
- Hackensack Meridian Health (Hackensack, NJ)
- …including Hospitalists, to ensure appropriate length of stay, time of day discharge, medical chart completion, and utilization review . **Regulatory Affairs** ... more
- Sharp HealthCare (San Diego, CA)
- …all accounts in rep assignment or alpha split. Contact hospital departments such as Medical Records, Utilization Review or external review organizations ... more
- Ochsner Health (New Orleans, LA)
- …basis. When needed will assist with daily clinical review of patient's medical records for utilization review purposes. Works independently with minimal ... more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print...over the nursing staff engaged in utilization review activities at Los Angeles General Medical ... more
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