- Novo Nordisk Inc. (Shreveport, LA)
- …obesity to maximize sales within an assigned territory. The Obesity Care Specialist (OCS) must achieve sales goals by implementing marketing and sales strategies ... brand strategies and the implications and importance of generating advocacy and support for them Partner with the Novo Nordisk Sales/Marketing Departments to… more
- Blanchard Valley Hospital (Findlay, OH)
- PURPOSE OF THIS POSITION The primary purpose of the Professional Coding Integrity Specialist (PCIS) is to review , enter and/or modify charges as appropriate, ... identify opportunities, and collaborate with RI Educator and/or Claims Resolution Specialist to avoid/reduce future edits. Support Condition 44 notifications… more
- Marion County (Salem, OR)
- …partners, work as a member of a highly skilled multidisciplinary treatment team, and support individuals to achieve their highest level of health. You will not only ... initiate authorization process for requests for Long-Term Psychiatric Care.Ensure accuracy of utilization data of those admitted to the Oregon State Hospital and… more
- Blanchard Valley Hospital (Findlay, OH)
- …investigational or potential compliance risks. Duty 7: Work with Coding Claims Resolution Specialist (CCRS) to review denial trends, whether coding related or ... the PCIS job functions as necessary. Provides general coding support as well as education and training for new...other departments to provide accurate and credible guidance. Duty5: Review of quarterly internal quality audits of the PCIS… more
- Careerbuilder-US (Atlanta, GA)
- …Coding experience. . Requires a minimum of 5+ years' experience in Health Insurance/quality chart audits and/or Utilization Review . Bachelor's degree required. ... 95% accuracy on coding quality audits. Job Responsibilities: . Compile chart review findings statistics, analyze data results and implement meaningful action plans… more
- BayCare Health System (Cotton Plant, AR)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding ... services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote...and compassionate team. **The Utilization Review Specialist Senior responsibilities… more
- BayCare Health System (Cotton Plant, AR)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Denials Specialist - Utilization Review responsibilities include:** + Timely reviews ... year Medicaid/Medicare experience. Equal Opportunity Employer Veterans/Disabled **Position** Denials Specialist - Utilization Review **Location**… more
- McLaren Health Care (Bay City, MI)
- …management to expedite patient discharge. 4. Maintains current knowledge of hospital utilization review processes and participates in the resolution of ... Summary_** **:** In conjunction with the admitting/attending physician, the UR Specialist RN assists in determining the appropriate admission status based on… more
- The Mount Sinai Health System (New York, NY)
- …Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The Utilization Review Specialist coordinates scheduling of all surgical/endoscopic ... ** Utilization Review Admission Specialist ...up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experience discrimination. + Inspiring and… more
- Desert Parkway Behavioral Healthcare Hospital (Las Vegas, 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 ... Officer/Medical Director as appropriate. + Coordinates an interdisciplinary approach to support continuity of care. + Provides utilization management, transfer… 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 ... Officer/Medical Director as appropriate. + Coordinates an interdisciplinary approach to support continuity of care. + Provides utilization management, transfer… more
- Corewell Health (Caledonia, MI)
- …and well-being should be within reach for all. We believe the system to support the entire health and wellness journey starts with prevention. We believe that ... continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and provides… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose....net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will… more
- Cleveland Clinic (Stuart, FL)
- …nurses, and other caregivers in a family-oriented, supportive environment. As a PRN Utilization Management (UM) Specialist , you will perform UM activities, such ... as admission review , concurrent review , retrospective chart ...Has at least two years of care management or utilization management experience. + Has excellent organizational and communication… more
- Cleveland Clinic (Weston, FL)
- …Miami-Fort Lauderdale metro area and remains a top hospital in Florida. As a Utilization Management (UM) Specialist , you will work under the general supervision ... Team Manager to perform UM activities which include admission review , concurrent review , retrospective chart review...or Case Manager. + Has a flexible schedule to support department needs. + Strong computer skills. + Demonstrates… more
- Sanford Health (SD)
- …level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to assure ... relating to determination of medical necessity, authorization, continued stay review including diagnosis and procedural coding for working diagnosis related… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Physician Specialist collaborates with the healthcare team in the management and resolution of activities that ... patient population and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- Huron Consulting Group (Chicago, IL)
- …as the expert you are now and create your future. **Qualifications** The Utilization Management Specialist is responsible for ensuring the appropriate ... to facilitate optimal patient outcomes while managing healthcare costs. The Utilization Management Specialist ensures compliance with regulatory requirements and… more
- Katmai (Usaf Academy, CO)
- …for inpatient/outpatient precertification. **ESSENTIAL DUTIES &** **RESPONSIBILITIES** + Review precertification requests for medical necessity, referring to the ... Medical Director those that require additional expertise. + Review clinical information for concurrent reviews. + As part of the UMRN program, conduct ongoing… more
- Tri-State Generation and Transmission Association, Inc. (Craig, CO)
- …available and the position will be filled at one of three job grade levels: IT Client Support Specialist I, job grade 6, IT Client Support Specialist II, ... job grade 7; or IT Senior Client Support Specialist , job grade 8. This decision...conference and training rooms. + Responsible for general SCCM utilization and support . + May be asked… more
