- Novo Nordisk Inc. (Albuquerque, NM)
- …sales and marketing resources to expand the breadth and depth of appropriate utilization Novo Nordisks products, consistent with label and company policy Analyze and ... exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications Bachelor or equivalent...the job titles are the following : Obesity Care Specialist I - $65,850 to $115,240 Obesity Care … more
- Modern Technology Solutions, Inc. (Redstone Arsenal, AL)
- Own Your Future. Modern Technology Solutions, Inc. (MTSI) is seeking a IT Computer/Software Specialist to join our growing team in Huntsville, AL. Why is MTSI known ... assistance and support related to computer systems, hardware, or software. Review existing technical solutions for improvements and efficiencies. Performs analysis… more
- MetroHealth (Cleveland, OH)
- ** Utilization Review Specialist - Utilization Management** **Location:** **METROHEALTH MEDICAL CENTER** **Biweekly Hours:** **80.00** **Shift:** **8a to ... **Responsible for communicating information to internal and external customers of the Utilization Review and Care Management Department. Follows up on inquiries… 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
- 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 (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
- McLaren Health Care (Bay City, MI)
- …management to expedite patient discharge. 4. Maintains current knowledge of hospital utilization review processes and participates in the resolution of ... Summary_** **:** In conjunction with the admitting/attending physician, the UR Specialist RN assists in determining the appropriate admission status based on… 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- Immigration and Customs Enforcement (IN)
- …Director for Healthcare Compliance, Office of Health Plan Management. The Senior Utilization Review Consultant will report directly to the IHSC Regional ... position Responsibilities DUTIES AND RESPONSIBILITIES: Serves in the capacity of Senior Utilization Review Consultant and subject matter expert in program… more
- Sanford Health (Sioux Falls, SD)
- …level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to assure ... relating to determination of medical necessity, authorization, continued stay review including diagnosis and procedural coding for working diagnosis related… more
