- 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=)… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), NYC Children's Center, Queens Campus, P25875 Occupational Category ... Code 11426 Minimum Qualifications NYC Children's Center is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and… more
- Trinity Health (Silver Spring, MD)
- …Type:** Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review , under the supervision and in collaboration with the ... activities of hospital staff in inpatient care coordination and utilization review . Oversees interactions of staff with...denials prevention and management staff to ensure a low medical necessity denial rate. Supports the Mission of Trinity… more
- Health Advocates Network (Medford, OR)
- Health Advocates Network is urgently hiring Discharge Planning and Utilization Review Registered Nurses (RNs) in the Medford, OR area. Must have 2 years of ... Discharge Planning and Utilization Review experience. * Pay Rate: $2,608...opportunities. Benefits We Offer: Competitive pay rates, Referral Bonus, Medical , Dental, Vision and 401k. Travel reimbursement… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... Utilizes available resources to promote quality, cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for… more
- LifeCenter Northwest (Bellevue, WA)
- Organ Utilization Administrative Coordinator Job Details Job Location Bellevue - Bellevue, WA Position Type Full Time Salary Range $23.55 - $34.15 Hourly Description ... and Qualifications The Organ Utilization Administrative Coordinator is responsible...accurately and timely completes the monthly expense report. + Travel coordination - books hotel, flights, rental vehicles, conference… more
- LifeCenter Northwest (Bellevue, WA)
- Organ Utilization Coordinator I Job Details Job Location Bellevue - Bellevue, WA Position Type Full Time Salary Range $66,122.00 - $95,904.00 Salary Description and ... Qualifications The Organ Utilization Coordinator (OUC) is accountable for all activities related to the allocation and utilization of organs from donors. This… more
- CVS Health (Phoenix, AZ)
- …care experience is in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience Managed Care + ... residence. Shift times may vary occasionally per the need of the department.** **No travel is required.** As a Utilization Management Nurse Consultant, you will… more
- CVS Health (Austin, TX)
- …Suite (PowerPoint, Word, Excel, Outlook) Preferred Qualifications: + 1+ years' experience Utilization Review experience + 1+ years' experience Managed Care + ... make health care more personal, convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is fully remote and employee can… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …optimize member care and ensure a constructive provider experience + Facilitate review process by communication with members/families, providers, medical staff ... BCBSMA utilization management process + Collaborate with members/families, providers, medical staff and/or other members of the treatment team to coordinate and… 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 ... **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40...position, exclusions may apply for some roles (for example: Travel , PRN, Short-Term Option, etc.). Actual compensation offer will… 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
- Commonwealth Care Alliance (Boston, MA)
- …The Manager, Utilization Management reports to the Director of Utilization Management * Oversees clinical decision review for services requiring ... Utilization Mgmt Essential Duties & Responsibilities:...review * Ensures timely and accurate communications of medical necessity review results to the original… more
- McLaren Health Care (Detroit, MI)
- … records/billing or healthcare related field + Two years of case management or utilization review , billing, or coding experience + Three years of recent ... determine the appropriate hospital setting (inpatient vs. observation) based on medical necessity. 2. Performs concurrent and retrospective utilization … more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, ... benefit coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist, will analyze clinical information, contracts,… more
- Humana (Columbus, OH)
- …and external customers and stakeholders. **Preferred Qualifications** + Experience with utilization review process. + Experience with behavioral change, health ... and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization … more
- Holcim US (Houston, TX)
- Carbon Capture Utilization Storage Integration Manager Requisition ID: 9456 Location: Houston, TX, US, 77547 Pay Type: Salary Travel Requirement: 31-40% **ARE ... and Solutions & Products. Description: **ABOUT THE ROLE** The Carbon Capture Utilization and Storage Integration Manager will report to the Senior Project Manager… more
- Katmai (Usaf Academy, CO)
- …need for inpatient/outpatient precertification. **ESSENTIAL DUTIES &** **RESPONSIBILITIES** + Review precertification requests for medical necessity, referring ... Medical Director those that require additional expertise. + Review clinical information for concurrent reviews. + As part...Minimum of two (2) years of prior experience in Utilization Management. + Must possess a current, active, full,… more
- InnovaCare (San Juan, PR)
- … Review Nurse (CRN) POSITION DESCRIPTION Manages the inpatient utilization of healthcare resources and develops, coordinates and implements the discharge ... review admissions and continued stay to determine appropriate Utilization , Quality Assurance, Risk Management and Discharge Planning Needs.2. Validates all… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... for Healthcare Professional (AHA BLS Healthcare) - American Heart Association; Certified Medical Assistant (CMA) - California Certifying Board for Medical … more
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