- VNS Health (Manhattan, NY)
- VNS Health is seeking a Registered Nurse (RN) Utilization Review for a nursing job in Manhattan, New York.Job Description & RequirementsSpecialty: Utilization ... review , including the design, testing and evaluation of the review methodology.Performs utilization and quality assessment reviews to maintain compliance… 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
- 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
- ProMedica Health System (Toledo, OH)
- The Payor Specialist is responsible for payor notification, and securing authorizations for all admissions systemwide. They receive and answer voicemail and process ... notification of all inpatient and observation admissions systemwide with per payor contract via phone, fax, and payer portals...using various WQs assigned in Epic. Submits clinical information per payor contract via payer portals, fax or Secure… 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 ... **JOB DESCRIPTION** ** Utilization Review Admission Specialist ...funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN 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 LVN II will facilitate, coordinate and approve… 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
- The Mount Sinai Health System (New York, NY)
- …of services **RESPONSIBILITIES** Responsible for all aspects of the concurrent review program, insurance certification, and authorization process for all Psychiatric ... by management) and for all aspects of the initial review on an as needed basis Develops rapport with...providers as well as regulatory agencies, as needed for Utilization Management activities Demonstrates the knowledge and skills necessary… more
- Kepro (AR)
- …Hygienist Reviewer to join our growing team. Summary Description The Dental Clinical Specialist is responsible for the Utilization Management and Utilization ... of dental health policy and preventative treatment plans. The Dental Clinical Specialist will complete their work with a limited degree of supervision.… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Surgical Review Specialist prospectively reviews, validates, and audits procedure code assignment ... lost with feedback to respective departments + Conduct concurrent review with utilization review department...AND SENSORY DEMANDS: Sitting for up to 7 hours per day, 3 hours at a time. Repetitive arm/finger… more
- Katmai (Usaf Academy, CO)
- …for inpatient/outpatient precertification. **ESSENTIAL DUTIES &** **RESPONSIBILITIES** + Review precertification requests for medical necessity, referring to the ... Medical Director those that require additional expertise. + Review clinical information for concurrent reviews. + As part...Minimum of two (2) years of prior experience in Utilization Management. + Must possess a current, active, full,… more
- MyFlorida (Fort Myers, FL)
- …provisions of Chapter 60L-36, Florida Administrative Code. OSTDS Program: The environmental specialist is expected to review residential applications and plans, ... ENVIRONMENTAL SPECIALIST II - 64006658 1 Date: Aug 29,...for performing assigned program state inspections at least once per year and starting enforcement of in instances of… more
- Dartmouth Health (Lebanon, NH)
- …capacity analysis. * Analyzes inventory/product data, utilizing customized query utilization reports and formulates recommendations for adjustments as necessary to ... and positive financial outcomes * Meets with department managers or directors to review PAR statistical data and makes recommendations for adjustments which meet the… more
- Integra Partners (Troy, MI)
- …do whatever it takes to get things done. PREFERRED SKILLS: + Certification in Utilization Review or Case Management + Experience with health insurance operations ... our Operations Training & Development team as an Operations UM Training Specialist , specializing in Utilization Management (UM) processes. The ideal candidate… more
- MetroLink (Los Angeles, CA)
- Special Services Employee (TEMP) - Finance Specialist II (Accounts Payable) Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4620361) Apply ... Special Services Employee (TEMP) - Finance Specialist II (Accounts Payable) Salary $1,827.77 - $2,834.85 Biweekly...APPLY: This is a continuous recruitment, with the first review of applications beginning August 26, 2024. Interested applicants… more
- Providence (Portland, OR)
- …provide drug therapy management and consultative services which will include a review of participant's drug profiles, working with prescribers to optimize drug ... Efforts will focus on optimizing drug therapy outcomes, improving drug utilization , improving patient compliance, preventing adverse drug events, and acting as… more
- Air Education and Training Command (Holloman AFB, NM)
- …Use Airspace (SUA) or Special Activity Airspace (SAA) recommendations, utilization review , documentation, administration, collaboration and impact implication ... mission on matters pertaining to requirements, justification, acquisition, and utilization of tactical airspace associated with aircrew and training. Requirements… more
- HCA Healthcare (Overland Park, KS)
- …growth, we encourage you to apply for our Consulting Provider Solutions Specialist opening. We promptly review all applications. Highly qualified candidates ... Do you have the career opportunities as a Consulting Provider Solutions Specialist you want with your current employer? We have an exciting opportunity… more
- Clark County, NV (Las Vegas, NV)
- SENIOR FAMILY SERVICES SPECIALIST Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/4631856) Apply SENIOR FAMILY SERVICES SPECIALIST ... is seeking qualified candidate to apply for the Senior Family Services Specialist Position. This position performs a variety of professional casework duties, to… more
- New York State Civil Service (Syracuse, NY)
- …Homeland Security and Emergency Services, Division of Title Fire Protection Specialist 1/Trainee 1/Trainee 2 (NY HELPS) Occupational Category Other Professional ... Type Permanent Jurisdictional Class Competitive Class Travel Percentage 60% Workweek Mon-Fri Hours Per Week 37.5 Workday From 8 AM To 5 PM Flextime allowed? No… more
