- Covenant Health Inc. (Louisville, TN)
- …is desired. Licensure Requirement: Current RN or Therapy license. Apply/Share Job Title UTILIZATION REVIEW COORD ID 4122409 Facility Peninsula, a Division ... Overview Utilization Review Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift Peninsula Overview: Peninsula, a division of Parkwest… more
- Northern Light Health (Pittsfield, ME)
- …resource referrals as necessary. + Manage assigned case load, assessing utilization of resources and services, identifying patients that require additional ... positive and receptive to change. + Manage assigned panels, assessing utilization of resources and services, identifying patients that require additional management… more
- UPMC (Pittsburgh, PA)
- …face to face assessments that include a clinical assessment and treatment, a review of the medical, functional, behavioral, pharmaceutical, and social needs of the ... member, including instrumental activities of daily living. Review UPMC Health Plan data and EMR data and documentation in the member electronic health records as… more
- BronxCare Health System (Bronx, NY)
- …Minimum of three (3) years experience specifically in Behavioral Health Utilization review and casemanagement.Managed Care or Discharge Planning experience ... Overview The Coordinator-Behavioral Health Utilization Management (BH-UMC) will review and monitor all patientsadmitted into psychiatry or substance abuse for… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …for all EHC operating units, coordinating room assignments to optimize bed utilization across the health system, critically thinking to manage appropriate patient ... of care. Uses advanced clinical knowledge and medical chart review to direct proper patient placement at each operating...patient placement at each operating unit. + Supports efficient utilization of EHC beds in accordance with established health… more
- Penn Medicine (Philadelphia, PA)
- …optimal reimbursement for the hospital for services provided. Responsibilities: + Review chemo schedule in advance and determines patients insurance requirements for ... to patient arrival. Assess information for appropriateness of setting and utilization of resources to optimize patient outcomes and cost effectiveness. Maintain… more
- University of Rochester (Rochester, NY)
- …Physicians, etc.), sets priorities and implements problem solving skills to receive, review , respond to, record and fill supply orders. Utilizes knowledge and ... ongoing practice of fiscal responsibility in review and approval of received orders. **RESPONSIBILITIES:** + Reviews,...of supplies in various areas. Supports and maintains space utilization . Executes monthly journal entries for supplies issued. +… more
- University of Rochester (Rochester, NY)
- …that enhance caregiver adaptation to improve child health outcomes and healthcare utilization . As part of our program, the research coordinator will closely partner ... interviews, conducting qualitative data analysis (mentored by the PI), literature review , and writing or contributing to academic products (abstracts, posters,… more
- Hackensack Meridian Health (Hackensack, NJ)
- …of the Nurse Manager or Administrative Supervisor (AS), performs accurate review , modify and correct employee schedules, timecards, punches and exception schedules, ... identifying patient?s needs and utilizing the resources available to facilitate optimum bed utilization . Places the patient in the right bed at the proper level of… more
- Mount Sinai Health System (New York, NY)
- …and documentation of departmental activities; + Investigate and organize utilization of system integrations/interfaces + Collaborate with research, regulatory, and ... teams to ensure overall completion of goals and deadlines + Collect, review , organize, and assemble regulatory submissions; + Distributes and tracks financial… more
- University of Rochester (Rochester, NY)
- …accuracy of patient schedules. Reviews provider schedules to ensure maximum utilization . + Negotiates down-payments and authorizes repayment status for high dollar, ... referral, verification, and/or service authorization in advance of treatment through review of dental insurance benefits and requirements. + Performs other duties… more
- University of Rochester (Rochester, NY)
- …and data reporting. + Work with Strong Ties leadership and Dept of Psychiatry Utilization Review team to address documentations concerns in a timely way and ... problem-solving reduction in risk of noncompliance going forward. + Prepares for and participates in regulatory surveys for ACT with the Strong Ties Leadership team and engages in the development, monitoring and evaluation of Performance Improvement Plans… more
- University of Rochester (Rochester, NY)
- …accuracy of patient schedules. Reviews provider schedules to ensure maximum utilization . 6. Negotiates down-payments and authorizes repayment status for high dollar, ... referral, verification, and/or service authorization in advance of treatment through review of dental insurance benefits and requirements. 15. Performs other duties… more
- Nuvance Health (Danbury, CT)
- …for providing strategic leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff ... *System Care Coordination Leader* will be responsible for leading a team encompassing utilization review and denials/appeals specialists and will need to foster… more
- Nuvance Health (Norwalk, CT)
- …principal liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and Health Information Management to ensure ... coming in from other hospitals. Responsibilities: 1. Manages the Utilization Review elements of the ED encounter...Working conditions: Essential: * Some manual skills / motor coord & finger dexterity * Little or no potential… more
- HCA Healthcare (El Paso, TX)
- …the following:** 1. **Implementation and support of division-wide standardization, utilization , integration, and optimization activities related to CPOE and other ... other division or facility service resources.** 5. **Evidence Based Order set review , approval, and build within the facility.** 6. **Ongoing monitoring of various… more
- Nuvance Health (Danbury, CT)
- …principal liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate ... level within the care continuum. Provides clinically based concurrent review of the medical record to assess and procure...Working conditions: Essential: * Some manual skills / motor coord & finger dexterity * Little or no potential… more
- Nuvance Health (Poughkeepsie, NY)
- …prepares Case Management reports and assists with creating presentations for monthly Utilization Review Committee meetings. 3. Assists staff in identifying gaps ... in the payroll system and submits it for final review by department leader. API editor for the department....months of hire Working Conditions: Manual: significant manual skills/motor coord & finger dexterity Occupational: Little or no potential… more
- Nuvance Health (Norwalk, CT)
- …principal liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate ... to the appropriate level within the care continuum. Provides clinically based concurrent review of the medical record to assess and procure accurate and complete… more
- Nuvance Health (Poughkeepsie, NY)
- …management of patient care to an assigned group of patients through the utilization Standards of Practice and policies and procedures and in collaboration with other ... forces as requested. * Participates in the discussion and review of articles in the field of hyperbaric oxygen....Working conditions: Essential: * Significant manual skills / motor coord & finger dexterity * Little or no potential… more