- Kelsey-Seybold Clinic (Pearland, TX)
- …requests for medical and surgical procedures, services and admissions . The Utilization Review Specialist communicates with providers regarding pertinent ... **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews, benefit verification, and applying criteria to… 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 ... Management Criteria ( ie MCG ) b. Supports & Participates in pre- admission review , utilization management, and concurrent and retrospective review … more
- Spectrum Billing Solutions (Skokie, IL)
- …Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management ... to work 100% fully remote . Your Responsibilities: + Review patient admission and clinical information to... | UR Specialist | Revenue Cycle Utilization Review Specialist | ABA… more
- HonorHealth (Scottsdale, AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… 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 surgical/endoscopic hospital admissions , pre- admission testing and operating room… 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 ... 0 **Position Summary:** In conjunction with the admitting/attending physician, the UR Specialist RN assists in determining the appropriate admission status based… more
- ProMedica Health System (Toledo, OH)
- The Payor Specialist is responsible for payor notification, and securing authorizations for all admissions systemwide. They receive and answer voicemail and ... UM department. Completes timely initial notification of all inpatient and observation admissions systemwide with per payor contract via phone, fax, and payer portals… more
- Carle (Urbana, IL)
- …each applicable transfer, completes documentation per hospital guidelines.* Performs admission Utilization review on all direct admissions & transfers to ... Clinical Admission Specialist + Department: Transfer Coordination...Apply Now Position Summary: Facilitates and coordinates all direct admissions , interhospital transfers as well as transfers in accordance… more
- Fairview Health Services (St. Paul, MN)
- …implementation, and reporting of complex clinical data. The Utilization Management Specialist is responsible for the completion of admissions and continued ... and appropriate based on payer requirements. The utilization management specialist concurrently monitors the appropriateness of admission and continued stay… more
- Johns Hopkins University (Baltimore, MD)
- …effective recruitment strategies. + Utilization of AAMC and campus admission /enrollment reporting tools to collect and analyze admissions statistics ... Assists significantly with the file evaluation and interviews of applicants for admission . Participate during admissions committee meetings to discuss applicant… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will...in any inpatient setting. Performs telephonic and/or on site admission and concurrent review , and collaborates with… 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: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,... in any inpatient setting. Performs telephonic and/or onsite admission and concurrent review , and collaborates with… more
- LifePoint Health (Athens, TN)
- …seeking talent to fill the position of Intake Nurse and Utilization Specialist for ourGeroPsychDepartment.This job is permanent,full-time. Core competencies ... **Starr Regional Medical Center* **Title:** * Intake Nurse and Utilization Specialist * **Location:** *Tennessee-Athens* **Requisition ID:** *7412-6736* more
- Hackensack Meridian Health (Belle Mead, NJ)
- **Overview** **The Part Time Admissions Nurse Practitioner performs timely medical clearance reviews for all patients referred to Blake Recovery Center and Carrier ... Clinic. Assures all patients who present at Carrier's Admissions Department are appropriately evaluated and treated. Completes psychiatric history and mental status… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Reviews medical admission record & continued stay for plan of care, appropriateness of timeliness of services **Qualifications** + Masters degree ... Beth Israel **Responsibilities** Responsible for all aspects of the concurrent review program, insurance certification, and authorization process for all Psychiatric… 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
- HCA Healthcare (San Antonio, TX)
- …acute inpatient rehabilitation services prior to returning home. The Clinical Rehabilitation Specialist will review these patients daily until they have strong ... Specialist will assist and coordinate the in-take and pre- admission screening process. The Clinical Rehabilitation Specialist accurately documents… more
- Hackensack Meridian Health (Neptune, NJ)
- … admissions and observations as specified by the facility's Utilization Management/ Review Committee for documentation completeness and compliance with ... and serve as a leader of positive change. The Clinical Documentation Specialist facilitates improvement in the overall quality, completeness and accuracy of medical… more
- Trinity Health (Pontiac, MI)
- …regulations sources. **III Duties / Responsibilities:** 1 Performs all aspects of utilization review (observation, admission , concurrent and retrospective) ... RN licensure within the State of Michigan. Certified Professional in Utilization Review /Management preferred. **C** **Special Skill / Aptitudes** Understanding… more
- McLaren Health Care (Pontiac, MI)
- …and continued stay authorization. 4. Educates health team colleagues about utilization review , including role responsibilities tools, and methodologies. 5. ... certification. 7. Applies readmission quality screens during concurrent and retrospective case review and reviews cases, which do not meet screening criteria to… more