- UCLA Health (Los Angeles, CA)
- Description As the Utilization Management & Quality Review Specialist , you will be responsible for: + Managing service requests and potential quality ... issue cases, ensuring compliance with regulatory requirements for both utilization management and quality assurance processes + Ensuring that all cases are… more
- Kelsey-Seybold Clinic (Houston, TX)
- …The Utilization Review Specialist (LVN) will support the Utilization Review quality assurance initiatives including mock audits to ensure compliance. ... **Responsibilities** The Utilization Review Specialist (LVN) is responsible...as we continue to grow, our focus is providing quality patient care by adding to our team of… more
- Truman Medical Centers (Kansas City, MO)
- …into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Specialist 101 Truman Medical Center **Job ... training, coaching and consulting to outside organizations. **Job Description** The Utilization Specialist will verify all financial and insurance information,… more
- CaroMont Health (Gastonia, NC)
- …liaison to managed care organizations. Communicates with attending physicians regarding utilization issues. Collaborates with discharge planning specialist and ... clinical reviews/appeals as part of denial process. The UR Specialist will be cross trained to work for the...NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management, Quality and/or Case… more
- Veterans Affairs, Veterans Health Administration (Walla Walla, WA)
- Summary The Acquisition Utilization Specialist is located at the Jonathan M. Wainwright Memorial VA Medical Center with Supply Chain Management service and is ... located in Walla Walla, Washington. Responsibilities As the Acquisition Utilization Specialist you will serve as the medical center liaison and advisor on… more
- Veterans Affairs, Veterans Health Administration (Minneapolis, MN)
- Summary As the Acquisition Utilization Specialist you will serve as the medical center liaison and advisor on contract related services focusing on critical ... wide variety of items to include specialized services. Responsibilities The Acquisition Utilization Specialist will render expert contract pre-award and post… more
- Henry Ford Health System (Troy, MI)
- …of pharmacy services, decrease waste, and rework in the region, and improve drug utilization . The Pharmacy Specialist will be instrumental in guiding the further ... GENERAL SUMMARY: The Pharmacy Specialist provides oversight and leadership for appropriate drug...to develop and implement strategies which continuously improve the quality of patient care at the best value for… more
- Craig Technologies (Houston, TX)
- Title: Communications RF On-Board Networks Utilization Specialist (CRONUS) Location: Johnson Space Center, TX Clearance: National Agency Check and Inquiries ... has an opening for a Communications RF On-Board Networks Utilization Specialist (CRONUS) at Johnson Space Center,...and the impact of failing to meet schedule or quality requirements. Position Requirements: Bachelors of Science in Engineering… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality , cost-effective care. The ... duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency...and retrospective reviews on all patients. Monitors level and quality of care. + Responsible for the proactive management… more
- Sutter Health (Berkeley, CA)
- …Collaborate with case managers, clinical nursing staff and others to ensure appropriate utilization and quality care through utilization review, tracking and ... to justify acute hospital admission, need for continued stay, and proper utilization of physician, nursing, and ancillary services. Responsible for concurrent review… more
- Sharp HealthCare (San Diego, CA)
- …pharmacy team members, and payers to ensure appropriate reimbursement and drug utilization . This member is expected to work effectively and constructively with all ... Experience working with controlled substances **Essential Functions** + Drug Utilization ResponsibilitiesEfficiently screens payor-specific requirements to ensure that most… more
- ManpowerGroup (Durham, NC)
- Our client, the largest health care industry, is seeking a utilization management specialist to join their team. If you are detail-oriented, experienced in ... we encourage you to apply for this remote opportunity. **Job Title:** Utilization Management Specialist **Location: REMOTE** **Pay Range: $24/hr on w2**… more
- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …Time + Employee Discount Program + Employee Assistance Program Job Description: The Utilization Review Specialist is responsible for monitoring adherence to the ... hospital's utilization review plan to ensure the effective and efficient...experience. + 2-3 years experience working as a UR Specialist , Medical Billing or health care quality … more
- Hawaii Pacific Health (Honolulu, HI)
- …experience and training, as well as internal peer equity. **Position** Specialist , Managed Care - Utilization Mgmt **Category** Administrative **Employment ... and other caregivers serving Hawai'i and the Pacific Region with high quality , compassionate care. Its four medical centers - Kapi'olani, Pali Momi, Straub… more
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- Summary As the Acquisition Utilization Specialist you will serve as the medical center liaison and advisor on contract related services focusing on critical ... This is not a virtual position. Position Description/PD#: Acquisition Utilization Specialist /PD99810A Relocation/Recruitment Incentives: Not Authorized Critical… 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...leaders and innovators; and supporting local communities by delivering high- quality care to all who need it. Through the… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay.… more
- Trinity Health (Pontiac, MI)
- …are cost effective and delivered in the most appropriate setting and optimized for quality and timeliness of the care. In collaboration with members of the health ... RN licensure within the State of Michigan. Certified Professional in Utilization Review/Management preferred. **C** **Special Skill / Aptitudes** Understanding of… more
- ManpowerGroup (Rancho Cucamonga, CA)
- **Job Title: Utilization Management Outpatient** **Duration: 6 months** **Location: Rancho Cucamonga, CA (Hybrid, Twice in a month)** **Pay rate: $23.98/hr.** **We ... are looking for an Utilization Management Outpatient** **to join one of our Fortune...three (3) years of experience as a data entry specialist or coordinator + High school diploma or GED… more
- Commonwealth Care Alliance (Boston, MA)
- …is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting ... in the area of service decisions and organizational determinations.The Manager, Utilization Management reports to the Director of Clinical Effectiveness. **What… more