• Utilization Review RN

    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
    Billings Clinic (11/05/24)
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  • Medical Director of Utilization

    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
    Henry Ford Health System (11/06/24)
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  • Utilization Review RN

    Actalent (San Bernardino, CA)
    Description: As a part of the Utilization Management team the Utilization Review RN is a member of the Care Coordination team. The goal of care coordination ... as it relates to acute inpatient stay and post-acute facility stay. The Utilization Review RN Coordinates continuing care/outside services for value based risk… more
    Actalent (11/07/24)
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  • Professional Care Manager Utilization

    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
    UPMC (11/06/24)
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  • Supervisor Care Management RN - Sesh…

    Providence (Anchorage, AK)
    …planning, coordinating, and directly supervising the activities of the case management, utilization review , social services and navigation teams for assigned ... Managers upon hire + 2 years of Case Management experience including utilization review , care management, care coordination, discharge planning, or population… more
    Providence (11/01/24)
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  • Utilization Management Admissions Liaison…

    LA Care Health Plan (Los Angeles, CA)
    …providing clinical review and authorization for alternate levels of care, home health, durable medical equipment, and other discharge needs. Provides support to ... Utilization Management Admissions Liaison RN II (After Hours...Management Medical Director, on requests where determination requires extended review . Collaborates with the inpatient care team for facilitation/coordination… more
    LA Care Health Plan (10/23/24)
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  • Physician Assistant ( Home Based…

    Veterans Affairs, Veterans Health Administration (Wichita, KS)
    Physician Employment Contract and no significant restriction on moonlighting The Home -Based Primary Care (HBPC) Physician Assistant (PA) is a position ... Robert J Dole VA Medical Center is hiring a Physician Assistant to serve Veteran patients of the facility....(1) Participation in staff meetings, hospital committees, and peer review process (2) Demonstrate effective communication both down to… more
    Veterans Affairs, Veterans Health Administration (10/29/24)
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  • RN Utilization Management

    Sanford Health (Fargo, ND)
    …secondary physician reviewers and appropriate referrals for secondary level review * Detailed reviewing of medical records to help improve patient care/outcomes ... continuum for assigned patient populations. This position primarily focuses on Utilization Management activities such as: * Evaluate medical necessity, efficiency… more
    Sanford Health (11/05/24)
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  • Physician Advisor

    WellSpan Health (York, PA)
    …PRN/Per Diem General Summary Provides direct supervision of case management and utilization review activities performed by the WellSpan Case Management staff. ... + Is a member of and attends the monthly Utilization Review committee, identifies cases for ...of care and verify need for peer to peer review -discuss with the CM nurse and/or attending physician more
    WellSpan Health (10/18/24)
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  • Physician Advisor Denials Management

    CommonSpirit Health (Sacramento, CA)
    …in the community. **Responsibilities** **This is a remote position.** **Summary** The Utilization Management Physician Advisor II conducts clinical case reviews ... sites across the US from clinics and hospitals to home -based care and virtual care services CommonSpirit is accessible...for assuring quality patient care and effective and efficient utilization of health care services. This position will be… more
    CommonSpirit Health (09/20/24)
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  • Associate Chair of Oncology - Physician

    Mount Sinai Health System (NJ)
    …with their job descriptions and the VMG Compact + Participate in the annual physician performance review process in Oncology Services + **Engage in the ... for The Valley Hospital, The Valley Hospital Foundation, Valley Home Care, Valley Medical Group, ColigoCare, and Valley Research...Health System mean our doctors collaborate with the top physician leaders in medicine today. The Valley Hospital is… more
    Mount Sinai Health System (10/23/24)
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  • Physician (FT) - Associate Medical Director…

    Dartmouth Health (Keene, NH)
    physician leadership experience are preferred. Dartmouth-Hitchcock Keene is seeking a Physician Advisor (PA) with expertise in Utilization Management, Care ... Overview Associate Medical Director - Cheshire Hospital Medicine Physician Advisor The Cheshire Medical Center’s Department of Hospital Medicine is a collaborative… more
    Dartmouth Health (11/05/24)
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  • Director of Physician Resource Group

    HCA Healthcare (Brentwood, TN)
    …as patient flow, patient satisfaction, practice volume, billing and collections, service utilization , coding, physician and staff training + Have strategic and ... and personal growth, we encourage you to apply for our Director of Physician Resource Group opening. We promptly review all applications. Highly qualified… more
    HCA Healthcare (11/07/24)
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  • Cardiology Physician Clinical Reviewer

    Evolent Health (Columbus, OH)
    utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the culture. **What You'll Be Doing:** As a Cardiology, Physician Clinical Reviewer you will be a key member...Reviewer you will be a key member of the utilization management team. We can offer you a meaningful… more
    Evolent Health (08/29/24)
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  • Physician Clinical Reviewer, Hematology…

    Evolent Health (Columbus, OH)
    utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer, you will be a key member...Reviewer, you will be a key member of the utilization management team. We can offer you a meaningful… more
    Evolent Health (10/04/24)
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  • Director of Physician Services I

    HCA Healthcare (Atlantis, FL)
    …such as patient flow, patient satisfaction, practice volume, billing and collections, service utilization , coding, physician and staff training + You will have ... 21 states and the United Kingdom. We are looking for a Director of Physician Services I for our HCA Healthcare team where excellence creates excellence. **Benefits**… more
    HCA Healthcare (11/06/24)
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  • Director of Physician Services I

    HCA Healthcare (Idaho Falls, ID)
    …such as patient flow, patient satisfaction, practice volume, billing and collections, service utilization , coding, physician and staff training + You will have ... Healthcare colleagues invested over 156,000 hours impacting our communities. As a Director of Physician Services I with East Falls Primary Care, you can be a manager… more
    HCA Healthcare (09/25/24)
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  • Director of Physician Services II

    HCA Healthcare (Independence, MO)
    …such as patient flow, patient satisfaction, practice volume, billing and collections, service utilization , coding, physician and staff training + You will have ... **Introduction** Are you ready to manage in a new era as a Director of Physician Services II where building a healthier tomorrow is more than a job? Our Centerpoint… more
    HCA Healthcare (09/13/24)
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  • Instructor/Nurse Practitioner or Physician

    University of Colorado (Aurora, CO)
    **Instructor/Nurse Practitioner or Physician Assistant (Full-Time)** **Description** **University of Colorado Anschutz Medical Campus** **Department: Department of ... Division of Medical Oncology** **Job Title:** **Instructor/Nurse Practitioner or Physician Assistant (Full-Time) 1105** **Position #: 00827636 - Requisition #:… more
    University of Colorado (09/20/24)
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  • Physician (Vascular Surgery) EDRP Approved

    Veterans Affairs, Veterans Health Administration (San Antonio, TX)
    …and participates in the development of the new focus on the Medical Home and Patient Centric Care, Utilization Management, Patient Safety initiatives, and ... by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities The South Texas Veterans Health Care… more
    Veterans Affairs, Veterans Health Administration (09/12/24)
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