- Hired by Matrix (Wilson, NC)
- …all employees across all departments within operations. Assist with tracking and utilization of Learning Management System (LMS). Prepare and communicate ... to enhance organizations' team capacities for over three decadesAs a full -service search firm, we partner with companies across industries, including Financial… more
- Northeast Georgia Health System, Inc (Braselton, GA)
- …of the pre-certification process.Works in conjunction with Physician offices, Case Management , Utilization Review, and patients to obtain supporting clinical ... of our communities. About the Role:Job SummaryUnder the supervision of the Utilization Review Manager, this position is responsible for ensuring the delivery of… more
- Blanchard Valley Hospital (Findlay, OH)
- …OF THIS POSITION The primary purpose of the Professional Coding Integrity Specialist (PCIS) is to review, enter and/or modify charges as appropriate, including ... opportunities, and collaborate with RI Educator and/or Claims Resolution Specialist to avoid/reduce future edits. Support Condition 44 notifications (inpatient… more
- Marion County (Salem, OR)
- …initiate authorization process for requests for Long-Term Psychiatric Care.Ensure accuracy of utilization data of those admitted to the Oregon State Hospital and ... acute care hospitals, provide routine reports to Marion County Management . May require overnight travel to participate in coordination meetings for individuals… more
- Compass Health Network (Rolla, MO)
- …client records, following agency and state regulations including knowledge of utilization management criteriaMaintain agreed upon level of customer care ... during Open Access. ESSENTIAL FUNCTIONS - JOB SPECIFIC Provide full assessments to individuals presenting to Open AccessAssessing appropriateness/readiness of… more
- Blanchard Valley Hospital (Findlay, OH)
- …or potential compliance risks. Duty 7: Work with Coding Claims Resolution Specialist (CCRS) to review denial trends, whether coding related or other, and ... Degree in a related field including, but not limited to, Health Information Management or 2+ years' experience from which comparable knowledge and abilities have… more
- Sanford Health (Sioux Falls, SD)
- …Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to ... utilization and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for… more
- AdventHealth (Tampa, FL)
- …Stroke Association as a Primary Stroke Center. **The role** **you'll** **contribute:** The Utilization Management (UM) Specialist works under the direction ... while understanding that **together** we are even better. **Schedule:** Full Time **Shift** :Days **The community** **you'll** **be caring...of the Utilization Management Manager and supports the Utilization … 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: Full Time Requisition ID: 11213 Salary Range: $88,854.00 (Min.)...net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN… more
- Cleveland Clinic (Stuart, FL)
- …nurses, and other caregivers in a family-oriented, supportive environment. As a PRN Utilization Management (UM) Specialist , you will perform UM activities, ... experience. + Has at least two years of care management or utilization management experience....of eligibility. **Work Experience:** + Requires three years equivalent full -time clinical experience as a Registered Nurse. + Prior… more
- Cleveland Clinic (Weston, FL)
- …the Miami-Fort Lauderdale metro area and remains a top hospital in Florida. As a Utilization Management (UM) Specialist , you will work under the general ... of the discharge plan. *Achieves a minimum of 85% on IRR quarterly. *Completes Utilization Management for assigned patients with a minimum of 25-30 reviews per… more
- Veterans Affairs, Veterans Health Administration (Minneapolis, MN)
- Summary The Acquisition Utilization Specialist serves as the Minneapolis VA Health Care System medical center liaison and advisor on contract related services ... This is not a virtual position. Position Description/PD#: Acquisition Utilization Specialist /PD99810S Relocation/Recruitment Incentives: Not Authorized Financial… more
- BayCare Health System (Cotton Plant, AR)
- …Employer Veterans/Disabled **Position** Denials Specialist - Utilization Review **Location** Clearwater:Morton Plant | Clinical | Full Time **Req ID** null ... of trust, dignity, respect, responsibility and clinical excellence. **The Denials Specialist - Utilization Review responsibilities include:** + Timely reviews of… more
- Desert Parkway Behavioral Healthcare Hospital (Las Vegas, NV)
- …an interdisciplinary approach to support continuity of care. + Provides utilization management , transfer coordnation, discharge planning, and issuance of ... The UR Specialist reviews and monitors patients' utilization ...and quality of care. + Responsible for the proactive management of patients with the objective of improving quality… more
- HonorHealth (Scottsdale, AZ)
- …communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... want to make an impact. HonorHealth offers a diverse benefits portfolio for our full -time and part-time team members designed to help you and your family live your… more
- Veterans Affairs, Veterans Health Administration (Marion, IN)
- …lines with in the VA Healthcare System (HCS). Responsibilities Duties: As the Acquisition Utilization Specialist you will serve as the medical center liaison and ... This is not a virtual position. Position Description/PD#: Acquisition Utilization Specialist /PD99492S and PD99810S Relocation/Recruitment Incentives: Not… more
- Hawaii Pacific Health (Honolulu, HI)
- …Services, which provides Hawai'i Pacific Health and its affiliates essential population utilization and financial management support, analyses and modeling. The ... referral management , patient steerage, and claims auditing. As the Specialist , you will be responsible for providing comprehensive managed care information… more
- Corewell Health (Caledonia, MI)
- …Location SITE - 4700 60th St - Grand Rapids Department Name Utilization Management - CHS Employment Type Full time Shift Day (United States of America) ... and continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and… more
- Hackensack Meridian Health (Hackensack, NJ)
- …a. Provides direction and support regarding CMS & NJDOH regulations governing Utilization Management & Clinical documentation. b. Oversight for accurate patient ... **Overview** The Senior Utilization Review Physician Specialist collaborates with...vs. Inpatient c. Liaison to the Medical Staff supporting Utilization Management Committee processes d. Hospital Based… more
- Katmai (Usaf Academy, CO)
- …+ Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full , and unrestricted Registered Nurses ... **REQUIREMENTS** None. **DESIRED QUALIFICATIONS &** **SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in… more
