- Cambia Health Solutions, Inc (Portland, OR)
- …provide utilization management (such as prospective concurrent and retrospective review ) to best meet the member's specific healthcare needs and to promote ... Behavioral Health Utilization Management Clinician Work from home within Oregon,...and evidence-based criteria to make informed determinations, consulting with physician advisors as necessary to ensure accuracy.Fosters collaboration with… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …in order for completion of the pre-certification process.Works in conjunction with Physician offices, Case Management, Utilization Review , and patients ... health of our communities. About the Role:Job SummaryUnder the supervision of the Utilization Review Manager, this position is responsible for ensuring the… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …to ensure appropriate feedback is received before product decisions are made. Utilization Review of necessity, quality, effectiveness and efficiency of medical ... of system-wide opportunities as they relate to Value Analysis standardization, utilization and implementation. Facilitate Value Analysis Teams (VAT) to most… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of individual patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team to ... members as needed to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure patients… more
- Merck & Co. (North Wales, PA)
- …identified growth opportunities supported by vaccine launches and through increased utilization of our inline vaccines. The Contracting and Distribution Strategies ... access to our vaccines for our customers, including Wholesalers/Distributers, Physician Organization, Buying Groups, Health Systems, Public Health Entities, Medical… more
- Novo Nordisk Inc. (San Francisco, CA)
- …and out of office across multiple account types: academic institutions, physician offices, and alternate site locations Routinely report territory-level market ... account plans to drive patient identification through market development and physician education; achieve sales goals, and maintain relationships in order to… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …at all campuses operated by NGHS. Collaborates with the physicians, patients, families, nursing, utilization review and other members of the health care team to ... length of stay based on working DRG/admitting diagnosis. Communicates with the physician , patient, family and other disciplines with the expected length of stay… more
- Northeast Georgia Health System, Inc (Braselton, GA)
- …care to patientsSkill in supervision (eg hire, train, assign and review work, motivate, prepare performance evaluations and effectively handle disciplinary ... the unit and works with the Charge Nurses to identify and address patient/family/ physician concerns. Interfaces with patients and families to ensure that care is… more
- Northeast Georgia Health System, Inc (Braselton, GA)
- …served. Establishes a plan of care consistent with the medical findings and Physician orders. Thoroughly evaluates, monitors, and reassesses all patients on a timely ... a team approach as demonstrated by cost management of patient stay and utilization for outside resources. Contributes to the effective operation of the department.… more
- Careers Integrated Resources Inc (Albuquerque, NM)
- …in pricing arrangements, contract requirements/language, benefits, membership, claims processing, utilization review , etc. . Process providers change forms. ... either internal staff or the provider to assure resolution. . Assist with the review of provider directories for the managed care networks. . Develop and maintain a… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of our communities. About the Role:Job SummaryResponsible for the systematic review of patient throughput including evaluating and implementing strategies and ... overall movement of patients in a safe, efficient manner and ensuring optimal utilization of resources, including, but not limited to; staff equipment and supplies,… 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 ... patient population and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- HCA Healthcare (Campbell, CA)
- …to five years of experience in Managed Care, Provider Office, or Utilization Review organization required Physician Services Group ... provides satisfaction and personal growth, we encourage you to apply for our Utilization Management RN opening. We promptly review all applications. Highly… more
- Billings Clinic (Billings, MT)
- …starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN Billings Clinic ... - 44.18 Under the direction of department leadership, the Utilization Review / Management RN. This position is...information supporting status or LOC, escalate case to the physician advisor for second level review as… 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
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 240830-5613FP-001 Location Middletown, CT Date Opened 9/5/2024 12:00:00 AM Salary ... Hospital - is accepting applications for one (1) full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=) position, in… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review Full Time Days -...based on Medical Necessity and submits case for Secondary Physician review per Tenet policy Ensures timely ... care and appropriate level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. (5% daily,… more
- Veterans Affairs, Veterans Health Administration (San Francisco, CA)
- Summary The Patient Flow Utilization Management/ Utilization Review Consultant RN functions with advanced knowledge and skills to provide clinical ... with a collaborative, inter-disciplinary practice setting. Responsibilities The Patient Flow Utilization Management/ Utilization Review Consultant RN is… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …resources and benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and promoting ... planners regarding transition to alternative levels of care. + Perform concurrent utilization review applying identified criteria at prescribed review … more
- Intermountain Health (Murray, UT)
- **Job Description:** The Healthy Connections (Care Management and Utilization Review ) AVP at Select Health oversees development and evaluation of utilization ... and innovative management of Select Health's Health Services care management and utilization management programs. Programs include but are not limited to acute,… more
Related Job Searches:
Medical Utilization Review Physician,
Physician,
Physician Review,
Physician Utilization,
Review,
Utilization,
Utilization Review,
Utilization Review Physician Advisor,
Utilization Review Physician Home,
Utilization Review Specialist Physician