- Novo Nordisk Inc. (West Hollywood, CA)
- …to deliver on this aspiration. The team is comprised of both our home office strategy and marketing execution teams and our field based teams focusing ... in helping people living with chronic disease achieve greater health outcomes. If you are passionate about being a...resources to expand the breadth and depth of appropriate utilization Novo Nordisks products, consistent with label and company… more
- HCR Home Care (Rochester, NY)
- Role and Responsibilities The Utilization Review Specialist is responsible for performing utilization review activities including technical audit of ... corrective action as needed. + Provide staff training for new Utilization Review initiatives and monitors the performance of assigned branches. + Participate… more
- Beth Israel Lahey Health (Burlington, MA)
- …Description:** The Inpatient Registered Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning ... in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital...review medical necessity and discharge planning) **As a health care organization, we have a responsibility to do… more
- BayCare Health System (Clearwater, FL)
- …team member be working remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Nurse - Health Plan **Location** ... Review + Managed care strongly preferred **Facility:** BayCare Health System, Utilization Management-BHS **Location:** **Park Place** **Status:** **Full… more
- Community Health and Counseling Services (Bangor, ME)
- Insurance Verification and Utilization Review Specialist - Health Services Job Type(s):Full-Time Location(s):Bangor, Maine Education:Associates Degree - ... patient insurances and verify eligibility and benefits and determine the primary payor for home health , mental health and hospice services. Obtain prior… more
- Centene Corporation (Austin, TX)
- …related to mental health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience ... role have the flexibility to work remotely from their home anywhere within the United States. **Position Purpose:** Performs...within the United States. **Position Purpose:** Performs a clinical review and assesses care related to mental health… more
- Ascension Health (Panama City, FL)
- **Details** + **Department: Utilization Review ** + **Schedule:FT day shift** + **Hospital:Ascension Sacred Heart Panama City** + **Location: Panama City, ... health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within… more
- UCLA Health (Los Angeles, CA)
- …for assessing and coordinating care for a diverse group of patients. This in-patient utilization review case manager position will work on-site at our UCLA ... a significant, positive difference in someone's life. At UCLA Health , you'll experience this joy every day while also...coordination of care. In this role you will perform utilization review while assuring the delivery of… more
- BayCare Health System (Clearwater, FL)
- …Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With ... foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions… more
- Spectrum Billing Solutions (Skokie, IL)
- …computer skills (Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | ... streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing...+ Flexible work environment - You can work from home , hybrid or fully in office. + Competitive Salary… more
- Munson Healthcare (Traverse City, MI)
- …interdisciplinary team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic work ... + Minimum of three years clinical experience required. Previous utilization review and/or case management in a...able to adapt to required software programs which support Utilization Management functions. Familiarity with health care… more
- Stanford Health Care (Palo Alto, CA)
- …processes between Health System and post-hospitalization service providers ( Home Health Agencies, Extended Care Facilities, Durable Medical Equipment ... and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge planning. +… more
- Ascension Health (Wamego, KS)
- … health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within ... healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee...across a number of hospitals, clinics, therapy centers and home health services. Ascension is a leading… more
- Sanford Health (SD)
- **Careers With Purpose** **Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many ... Sanford Family who are dedicated to the work of health and healing across our broad footprint.** **Facility:** Remote...Details** opportunity to work remote **Job Summary** Monitors the utilization of resources, risk management and quality of care… more
- US Tech Solutions (Columbia, SC)
- … health /chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years must ... week and then will be deployed to work from home . + NICE TO HAVE skill sets/qualities: Working knowledge...in direct intervention/patient education with members and providers regarding health care delivery system, utilization on networks… more
- Providence (Mission Hills, CA)
- **Description** Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records ... daily during admission for all payers, as required by the health plans. This role requires a strong clinical background combined with well-developed knowledge and… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and...a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT… more
- Intermountain Health (Las Vegas, NV)
- …the direction of a registered nurse, licensed physician, or other specified health care professional, participates in patient care commensurate to Scope of Practice. ... some in person responsibilities but also has the ability to work from home . Remote option available after initial training period.** + Additional Shift Details:… more
- VNS Health (Manhattan, NY)
- …CEU credits, and advancement opportunities What You Will Do + Reviews specific utilization issues or requests with Clinical Review team, focusing on problem ... Manages and evaluates staff in delivery and coordination of utilization management review services in compliance with...of care begins with you. Together, we will revolutionize health care in the home and community.… more
- Providence (Missoula, MT)
- …services also include physicians, more than 40 clinics, care centers, hospice and home health programs, and other diverse community services. Providence is proud ... Schedule:** Full time **Job Shift:** Day **Career Track:** Nursing **Department:** 3500 UTILIZATION REVIEW **Address:** MT Missoula 500 W Broadway **Work… more
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