- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** **The Utilization Review Physician 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
- Lawrence General Hospital (Lawrence, MA)
- …supervision and in collaboration with the Utilization Review Coordinator, Utilization Review Nurses, Physician advisor and healthcare team supports ... well as the integrated care team and supports the case management/ utilization review team on system-wide quality improvement/performance improvement initiatives.… more
- Community Health Systems (Franklin, TN)
- …additional documentation from the physician (s). + Escalates cases to the Utilization Review Manager and/or Physician Advisor if physicians are ... appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for… 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
- Beth Israel Lahey Health (Boston, MA)
- …a difference in people's lives.** Position Summary: In conjunction with the admitting/attending physician , the Utilization Review RN assists in determining ... the level of care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure… more
- CVS Health (Sacramento, CA)
- …* Experience with managed care, as a provider and manager of care utilization review or physician advisor experience. *Child/Adolescent Board Cert ... program/operational efficiency involving clinical issues * Provide leadership and day-to-day physician oversight for utilization management team, including the… more
- Catholic Health Initiatives (Chattanooga, TN)
- …by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. + Physician Advisor Sub-specialty Certification ... the hospital through teaching, consulting, and advising the care management and utilization review departments, medical staff members, and the hospital… more
- Hackensack Meridian Health (Neptune, NJ)
- …by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. + Physician Advisor Sub-specialty Certification ... teaching, consulting and advising of the care management and utilization review departments and hospital leadership. +...ensuring quality care is provided. + Develop expertise on physician practice patterns, over and under- utilization of… more
- Atlantic Health System (Morristown, NJ)
- …from ABQAURP (The American Board of Quality Assurance and Utilization Review Physicians), AAPL (American Association for Physician Leadership's Physician ... in Management course), or CPUR (Certification Program in Utilization Review ), Institute for Healthcare Improvement courses, or physician advisor training… more
- The County of Los Angeles (Los Angeles, CA)
- …Organization guidelines and the Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...by subordinate supervisors on number and status of reviews, physician advisor referrals, and type of physician … 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 ... State of Michigan. + Minimum of three years clinical experience required. Previous utilization review and/or case management in a hospital or insurance industry… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Manager of Utilization Review oversees a team of utilization review nurses and coordinators, ensuring compliance with clinical ... regulatory standards, and enhancing the overall utilization review process to optimize patient care...and common issues. + Efficiently refers cases to the Physician Advisor or representative of the UR committee when… 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
- 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
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr- CMC-Clear Lake Center - shift 3:00 PM-11:00 PM - Monday-Friday **Webster, Texas, United States** **New** Nursing & Care Management ... or observation in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and retrospectively… more
- HonorHealth (Scottsdale, AZ)
- …communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Baptist Memorial (Jackson, MS)
- Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed ... by utilization review standards. The UR Nurse works...necessity or other areas when indicated + Communicates with physician advisors related to status concerns or denials +… more
- Glens Falls Hospital (Glens Falls, NY)
- …can be foundhere. **Job:** **Nursing - Case Management* **Title:** *RN - Utilization Review Nurse* **Location:** *NY-Glens Falls* **Requisition ID:** *2410V* ... *The Impact You Can Make * Works in collaboration with the physician and interdisciplinary team to support the underlying objective of enhancing the quality of… 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...and operating roaom time. 7. Checks credentials system for physician 's delineation of privileges for equipment and/or procedures according… more
- Providence (Everett, WA)
- …years, OR recent Utilization Management experience **Preferred Qualifications:** + Utilization review or case management experience + Experience with ... **Description** Oversee utilization management and review of patients...care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice… more
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