- BayCare Health System (Cotton Plant, AR)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding ... and compassionate team. **The Utilization Review Specialist Senior responsibilities include:** + Functions as the primary liaison between the funding agents… more
- BayCare Health System (Winter Haven, FL)
- …a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + ... Critical Care or Emergency Service Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Specialist Senior **Location** Winter… more
- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …leadership, teamwork, and communication skills. ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical ... of candidates. Education Associates Degree preferred Minimum Work Experience Utilization Review experience preferably in a behavioral/psychiatric healthcare… more
- Amity Foundation (Tucson, AZ)
- …and enthusiastic individuals with a desire to teach, learn and join our community as a Utilization Review Specialist at our campus in Tucson, AZ. With this ... community building Remembrance, Resolution, Reconciliation, Restoration, Renewal About the Position Utilization Review Specialist you will contribute to… more
- Providence (WA)
- …the best people, we must empower them._** **Providence Health Plan is calling an Associate Utilization Review Specialist who will:** + Be responsible for all ... the following clinical teams: + Prior-authorization (PA) + Concurrent Review (CCR) + SNF + Clinical Claims + Coordinate...+ Clinical Claims + Coordinate and execute the medical review and research functions required to support all teams… more
- WestCare Foundation (Henderson, NV)
- Utilization Review Specialist Job Details Job Location Henderson - 1711 Whitney Mesa - Henderson, NV Position Type Full Time Education Level 2 Year Degree ... LPN or RN and/or Bachelors or Masters level CADC/LADC with 2 years utilization review experience, preferred experience working with individuals with psychiatric… more
- HonorHealth (Scottsdale, AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- The Mount Sinai Health System (New York, NY)
- …Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The Utilization Review Specialist coordinates scheduling of all surgical/endoscopic ... ** Utilization Review Admission Specialist (OR Scheduler),… more
- Spectrum Billing Solutions (Skokie, IL)
- …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR ... admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for… more
- BayCare Health System (Cotton Plant, AR)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Denials Specialist - Utilization Review responsibilities include:** + Timely reviews ... year Medicaid/Medicare experience. Equal Opportunity Employer Veterans/Disabled **Position** Denials Specialist - Utilization Review **Location**… more
- Desert Parkway Behavioral Healthcare Hospital (Las Vegas, NV)
- The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties ... include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency...of care that may be covered. + Monitors all utilization reports to assure compliance with reporting and turnaround… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties ... include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency...of care that may be covered. + Monitors all utilization reports to assure compliance with reporting and turnaround… more
- MetroHealth (Cleveland, OH)
- …**Responsible for communicating information to internal and external customers of the Utilization Review and Care Management Department. Follows up on inquiries ... from payors and provides the appropriate information to Utilization Review , providers, payors, and admitting. Upholds the mission, vision, values, and customer… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Physician Specialist collaborates with the healthcare team in the management and resolution of activities that ... patient population and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- Henry Ford Health System (Troy, MI)
- …The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and resolution process. ... information to payers as needed. * Maintain a current knowledge of Utilization Management through interaction with staff and payor portal representatives. * Identify… more
- Tufts Medicine (Burlington, MA)
- …, case management, and revenue cycle functions. 7.Provides clinical support to the utilization review and clinical documentation specialist for resolution of ... physician support for high quality, compliant and efficient workflows related to utilization review , clinical documentation, and revenue cycle coding and billing… more
- Baystate Health (Springfield, MA)
- …meetings to address treatment objectives. **6.** May collaborate as assigned with utilization review specialist to obtain necessary insurance authorizations ... is responsible for gathering a psychosocial evaluation through interviews and record review and completing a written assessment with case formulation and treatment… more
- Fairview Health Services (St. Paul, MN)
- …meets regulatory requirements. Participates in interdisciplinary communication related to utilization review issues. Educates on status. Provides all ... M Health Fairview has an immediate opening for a Utilization Management Specialist RN. This position provides...+ Current RN licensure in MN + 3-5 years utilization review or case management experience in… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve… more
- Cleveland Clinic (Weston, FL)
- …Miami-Fort Lauderdale metro area and remains a top hospital in Florida. As a Utilization Management (UM) Specialist , you will work under the general supervision ... of the UM Team Manager to perform UM activities which include admission review , concurrent review , retrospective chart review and clinical systems review … more
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