- 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 ... patient population and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), New York State Psychiatric Institute, P25685 Occupational Category ... New York State Psychiatric Institue is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and efficiency… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… 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 Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate, perform and complete assigned duties in providing care to… more
- Behavioral Center of Michigan (Warren, MI)
- Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination, implementation and reporting of complex ... clinical data and supports the operations of Samaritan Behavioral Center. The Utilization Review Coordinator reviews the patient's chart and records clinical… more
- Sutter Health (Berkeley, CA)
- …and others to ensure appropriate utilization and quality care through utilization review , tracking and evaluation and objectively compare criteria with ... clinical nursing staff and other departments regarding documentation required for utilization review activities and processes. Collaborate with medical, nursing… more
- Billings Clinic (Billings, MT)
- …starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN Billings Clinic ... $35.34 - 44.18 Under the direction of department leadership, the Utilization Review / Management RN. This position is to conduct initial, concurrent,… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …resources and benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and promoting ... regarding transition to alternative levels of care. + Perform concurrent utilization review applying identified criteria at prescribed review points, and… 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
- CaroMont Health (Gastonia, NC)
- …RAC for reversal of original determination. May serve on the Medical Record/ Utilization Review Committee, providing detailed logs of denial activity and appeal ... practice in NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management, Quality and/or Case Management preferred. Minimum… more
- Trinity Health (Columbus, OH)
- **Employment Type:** Part time **Shift:** **Description:** ** Utilization Review RN, Case Management** **Why Mount Carmel?** With five hospitals ... Carmel College of Nursing **About the job:** The **RN Case Manager, Utilization Review ** ensures that services are delivered in a manner that balances quality… more
- BayCare Health System (Clearwater, FL)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and ... compassionate team. **The Utilization Review Specialist Senior responsibilities include:** + Functions as the primary liaison between the funding agents and all… 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 ... Manages the activities of hospital staff in inpatient care coordination and utilization review . Oversees interactions of staff with outside activities and… more
- R1 RCM (Pittsburgh, PA)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. **Title: Utilization Review Author** **Location: Hospital Client located in ... EST. Hours may vary and some flexibility may be offered** As our ** Utilization Review Author** , you will help our hospital clients by working alongside our… more
- Trinity Health (Silver Spring, MD)
- …the activities of RN Case Managers for in inpatient care coordination and utilization review . Oversees interactions of staff with outside activities and agencies ... of Nursing experience in an acute healthcare setting. + Designation Changes and Utilization Review + Knowledge of pertinent regulatory, accreditation, public and… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring ... for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well as specified… more
- Covenant Health (Nashua, NH)
- …health care team. + Annual goals are achieved. + Attends pertinent case management/ utilization review programs to maintain current knowledge of UR practices. + ... and procedures. + Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all mandatory learning… more
- Actalent (Omaha, NE)
- …in medical review or utilization management. + Knowledge of utilization review , Medicare, utilization management, and EMR systems. Additional Skills ... Job Title: Utilization Management NurseJob Description We are seeking a...preauthorization processing. This role involves accurate and timely medical review of claims, preauthorizations, and customer service inquiries. You… more
- LifePoint Health (Hancock, MI)
- …our employees both professionally and personally. We are seeking a detail-oriented Utilization Review Registered Nurse to be responsible for prior authorizations ... testing along with determining medical necessity of patient while hospitalized. Our Utilization Review RN will be part of an excellent team of Case Management… more
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