- 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, Medical Groups, Individual… more
- 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
- 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...$176,872.80 Annually Location Los Angeles County, CA Job Type Full time Job Number Y5126D Department HEALTH SERVICES Opening… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- …- is accepting applications for a full -time Utilization Review ... Utilization Review Nurse Coordinator (40 Hour)...review of cases and case referral to a physician consultant for final disposition; + Performs related duties… more
- Henry Ford Health System (Detroit, MI)
- …practicing as a physician . + Previous experience as Director of Utilization Review or Physician Advisor preferred. CERTIFICATIONS/LICENSURES REQUIRED: + ... The Medical Director of Utilization Review is responsible for the...a timely manner 9. Code 44s - UM committee physician concurrent statement. CMS Conditions of Participation 10. Lead… more
- Mount Sinai Health System (New York, NY)
- …Admission Specialist (OR Scheduler), Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The Utilization Review Specialist coordinates ... testing and operating roaom time. 7. Checks credentials system for physician 's delineation of privileges for equipment and/or procedures according to medical… 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
- Stanford Health Care (Palo Alto, CA)
- …records to ensure the necessity and appropriateness of care provided. 3. Utilization Review : Conduct thorough utilization reviews, applying evidence-based ... and utilization management principles. + Experience in case management, utilization review , or related healthcare roles. + Strong clinical assessment… more
- Trinity Health (Silver Spring, MD)
- …Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review , under the supervision and in collaboration with the ... Manages the activities of hospital staff in inpatient care coordination and utilization review . Oversees interactions of staff with outside activities and… more
- Trinity Health (Silver Spring, MD)
- …the activities of RN Case Managers for in inpatient care coordination and utilization review . Oversees interactions of staff with outside activities and agencies ... Shift **Description:** **Job Title:** Manager Care Mgt & Util Review **Employment Type:** Full Time **Shift:** Day...in an acute healthcare setting. + Designation Changes and Utilization Review + Knowledge of pertinent regulatory,… more
- Trinity Health (Fort Lauderdale, FL)
- **Employment Type:** Part time **Shift:** **Description:** The Utilization Review (UR) Nurse has well-developed knowledge and skills in areas of utilization ... requirements of various commercial and government payers. On-Site Position** **_Position Purpose:_** Utilization Review (UR) Nurses play a vital role in… 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
- UPMC (Hanover, PA)
- **UPMC is hiring a Professional Care Manager to support the Utilization Review process! This is a full time, day shift position with a rotating weekend and ... the clinical and financial plan for patients. Performs overall utilization management, resource management, discharge planning and post-acute care referrals… more
- Providence (Anchorage, AK)
- …planning, coordinating, and directly supervising the activities of the case management, utilization review , social services and navigation teams for assigned ... retain the best people, we must empower them. **Hours: Full -time, 1.0 FTE, Day Shift, 40 Hours Per Week**...hire + 2 years of Case Management experience including utilization review , care management, care coordination, discharge… more
- Trinity Health (Boise, ID)
- …level reviews for patients not meeting inpatient criteria. C. Participates in local Utilization Review Committee and be a member of appropriate committees and ... **Work Experience** **Job Description:** Saint Alphonsus is seeking a physician leader to become our Medical Director of Documentation...accurate reporting of bed status. F. Assist case managers, utilization review nurses and social workers to… more
- UNC Health Care (Raleigh, NC)
- **Description** ** Full time exempt, 40 hours per week Utilization Manager - Medical necessity review for Surgical admissions** Become part of an inclusive ... episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to… more
- Hackensack Meridian Health (Perth Amboy, NJ)
- …**Hackensack Meridian** **_Health_** includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... and serve as a leader of positive change. The ** Utilization Management Care Coordinator** is a member of the...appropriate records as required by payer agencies and initiates physician advisor's review as necessary for unwarranted… more
- Hackensack Meridian Health (Neptune, NJ)
- …**Hackensack Meridian** **_Health_** includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team...appropriate records as required by payer agencies and initiates physician advisor's review as necessary for unwarranted… more
- Cleveland Clinic (Vero Beach, FL)
- …patient's hospital stay or visit. Some of the responsibilities of a Utilization Management Specialist include medical record review , providing clinical ... the UM Team Manager, this individual performs UM activities which includes admission review , concurrent review , retrospective chart review and clinical… more
