- 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 ... population and Hackensack UMC. These include but are not limited to utilization review ,** **hospital reimbursement, clinical compliance, case management, and… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the ... population and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- The County of Los Angeles (Los Angeles, CA)
- …administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the ... Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician...for and the effective conduct of the system to review patients' medical charts to ascertain the… more
- Munson Healthcare (Traverse City, MI)
- …interdisciplinary team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic work ... State of Michigan. + Minimum of three years clinical experience required. Previous utilization review and/or case management in a hospital or insurance industry… more
- Beth Israel Lahey Health (Boston, MA)
- …a difference in people's lives.** Position Summary: In conjunction with the admitting/attending physician , the Utilization Review RN assists in determining ... reviews as directed in the hospital's Utilization Review Plan and review of medical...necessity. 3. Actively seeks additional clinical documentation from the physician to optimize hospital reimbursement when appropriate. 4. Works… more
- Sutter Health (Berkeley, CA)
- …staff and other departments regarding documentation required for utilization review activities and processes. Collaborate with medical , nursing and other ... hospital administration, medical staff, patient registration and representatives of review organizations and others to ensure effective utilization of… 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 ... the physician (s). + Escalates cases to the Utilization Review Manager and/or Physician ...or to place in outpatient with observation services. + Review medical records for appropriate indicators of… more
- Lawrence General Hospital (Lawrence, MA)
- …supervision and in collaboration with the Utilization Review Coordinator, Utilization Review Nurses, Physician advisor and healthcare team supports ... well as the integrated care team and supports the case management/ utilization review team on system-wide quality improvement/performance improvement initiatives.… 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)
- …identified concerns to the treatment team, Director of Utilization Management, and the Medical Director. + Review charts at identified review points and ... a case by case basis. Applies case management and utilization review principles in monitoring the delivery...of cases with questionable medical necessity to Physician Advisor for determination. + Review clinical… 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 ... the physician (s). + Escalates cases to the Utilization Review Manager and/or Physician ...medical staff hospital's to perform an internal secondary review . The UR Clinical Specialist may assist coordinating a… more
- CaroMont Health (Gastonia, NC)
- …MCO, Medicare, or RAC for reversal of original determination. May serve on the Medical Record/ Utilization Review Committee, providing detailed logs of ... medical necessity will be performed and documented in medical review , including daily status update while...NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management, Quality and/or Case… 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 ... work with Trinity Health experts in managing and developing medical utilization programs and documentation initiatives. **Work...patients not meeting inpatient criteria. C. Participates in local Utilization Review Committee and be a member… more
- Medical Center Hospital (Odessa, TX)
- Position Summary: The Utilization Review Specialist/Outcomes Specialist conducts concurrent and retrospective review functions in support of the hospital ... Utilization Review Program and makes appropriate referrals to designated Physician Advisors. Education: Holds a current Texas license as a Registered Nurse.… more
- HonorHealth (Scottsdale, AZ)
- …communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... high quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation,… more
- Baptist Memorial (Memphis, TN)
- 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...and appropriate care. Areas of work include status management, medical necessity reviews, verification of authorization, resource utilization… more
- Dignity Health (San Bernardino, CA)
- …for more information. **Responsibilities** The Utilization Review Specialist is responsible for reviewing medical ... guidelines and critical thinking to support patient care and optimize resource utilization . **Key Responsibilities:** + Review medical records to… more
- Glens Falls Hospital (Glens Falls, NY)
- …can be foundhere. **Job:** **Nursing - Case Management* **Title:** *RN - Utilization Review Nurse* **Location:** *NY-Glens Falls* **Requisition ID:** *2410V* ... Will Fulfill Your Potential* *Responsibilities* * Conducts concurrent and retrospective review (s) utilizing InterQual (IQ) medical necessity criteria to monitor… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Review Admission Specialist (OR Scheduler), Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The ... Utilization Review Specialist coordinates scheduling of all...and operating roaom time. 7. Checks credentials system for physician 's delineation of privileges for equipment and/or procedures according… more
- Covenant Health (Lubbock, TX)
- …Schedule:** Full time **Job Shift:** Day **Career Track:** Nursing **Department:** 8000 UTILIZATION REVIEW **Address:** TX Lubbock 3615 19th St **Work ... for a targeted patient population. Carries out activities related to utilization management, discharge planning, care coordination and referral to other levels… more
Related Job Searches:
Medical,
Medical Physician,
Medical Utilization Review,
Physician,
Physician Review,
Review,
Utilization,
Utilization Review,
Utilization Review Physician