- Corewell Health (Royal Oak, MI)
- …3 years of relevant experience Three to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + ... patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2.… more
- Corewell Health (Farmington Hills, MI)
- …3 years of relevant experience Three to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + ... patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). +… more
- Corewell Health (Grosse Pointe, MI)
- …3 years of relevant experience Three to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + ... Functions + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). +… more
- Northwell Health (Huntington, NY)
- …in case management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. ... concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness of admission and continued length of stay. + Contacts… more
- LA Care Health Plan (Los Angeles, CA)
- …such as ambulatory care, home care, or case management. OR experience in Utilization Review or Care Management will be considered in lieu of direct patient ... and/or disabilities in a case/care management environment. Preferred: Experience in utilization review , skilled nursing, home health, discharge… more
- BayCare Health System (Largo, FL)
- …within the area of responsibility + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol + Oversees and ... **There's home care and then there's BayCare HomeCare!** Every...Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization … more
- BayCare Health System (Dunedin, FL)
- …the area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. + Oversees and ... **There's home care and then there's BayCare HomeCare!** It...Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization … more
- BayCare Health System (Largo, FL)
- …the area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. + Oversees and ... **There's home care and then there's BayCare HomeCare!** At...Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization … more
- BayCare Health System (Bradenton, FL)
- …the area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. + Oversees and ... **There's home care and then there's BayCare HomeCare!** Join...Participates with Case Manager on initial Plan of Care review with a focus on quality, utilization … more
- ChenMed (St. Louis, MO)
- …of 2 years' clinical work experience required + A minimum of 1 year of utilization review and/or case management, home health, discharge planning experience ... and discharge planning. **KNOWLEDGE, SKILLS AND ABILITIES:** + Knowledge of Utilization Review (UR) and discharge planning + Strong interpersonal and… 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 ... of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians....compassionate team. **The Utilization Review Specialist Senior responsibilities include:** +… more
- Sanford Health (MN)
- …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
- Ascension Health (Milwaukee, WI)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Ascension Health (Manhattan, KS)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Centene Corporation (Madison, WI)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... including a fresh perspective on workplace flexibility. **THIS POSITION IS REMOTE/WORK FROM HOME , WORK SCHEDULE WILL BE MONDAY-FRIDAY 8AM - 5PM DURING TRAINING, WITH… more
- Providence (Mission Hills, CA)
- **Description** Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records ... strong clinical background combined with well-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination. The … more
- Geisinger (Danville, PA)
- …key role in ensuring information is released to payers and physician level review . Frequently works with highly sensitive and confidential information. Job Duties + ... a resource to departmental staff regarding insurance contacts. + Maintains Utilization management SharePoint site to reflect updated payor information. +… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …1. Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted ... for appropriate status determination. 2. Ensures compliance with principles of utilization review , hospital policies and external regulatory agencies, Peer… more
- HCA Healthcare (Ogden, UT)
- …Apply Today! **Job Summary and Qualifications** The Mental Health Professional/ Utilization Review role primarily involves reviewing medical records ... guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... BE ONSITE FOR THE 1ST WEEK AND THEN WILL BE DEPLOYED TO WORK FROM HOME . WILL PROVIDE THE EQUIPMENT. + NICE TO HAVE skill sets/qualities: Working knowledge of… more
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