- Novo Nordisk Inc. (Lubbock, TX)
- …Sales Representative also assists their target physicians with their local clinical and educational initiatives by coordinating company resources (eg, counterparts, ... timely and accurate transmission of call data Understand the scientific and clinical underpinnings of brand strategies and the implications and importance of… more
- Novo Nordisk Inc. (Irvine, CA)
- …Sales Representative also assists their target physicians with their local clinical and educational initiatives by coordinating company resources (eg, counterparts, ... timely and accurate transmission of call data Understand the scientific and clinical underpinnings of brand strategies and the implications and importance of… more
- Harbor Health Services, Inc. (Mattapan, MA)
- … support to utilization team. Utilizes evidence-based standards and clinical expertise to review current role expectations, workflows, and standard ... Collaborates with Senior Medical Director to resolve complex medical review issues and utilization cases requiring elevation...operating procedures for gaps in care that may affect utilization . Performs clinical case reviews of high… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital ... collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review RN **Location** Tampa:St Josephs | Clinical | PRN **Req… more
- Community Health Systems (Franklin, TN)
- …information to secure timely authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist . + Monitors and ... **Job Summary** The Utilization Review Coordinator ensures efficient and...activities. This role collaborates with payers, hospital staff, and clinical specialists to secure timely authorizations for hospital admissions… more
- Deloitte (Los Angeles, CA)
- …registered nurse, physician, physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN, Quality, DRG ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk… more
- Spectrum Billing Solutions (Skokie, IL)
- …Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management ... will utilize his or her knowledge and skills to review clinical information and obtain initial and... | UR Specialist | Revenue Cycle Utilization Review Specialist | ABA… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry ... this position is able to cover a multitude of utilization review functions through point of entry,...clinical nursing experience, which includes three years in utilization review and/or case management **LICENSES AND… more
- CaroMont Health (Gastonia, NC)
- …RAC for reversal of original determination. May serve on the Medical Record/ Utilization Review Committee, providing detailed logs of denial activity and appeal ... NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management, Quality and/or Case...Case Management preferred. Minimum of three years experience in clinical area with clinical review … more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is ... responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients...and advocating for appropriate levels of care. The UR Specialist works closely with clinical staff, admissions,… more
- BayCare Health System (Clearwater, FL)
- …day per week in office Equal Opportunity Employer Veterans/Disabled **Position** Intake Specialist Utilization Review - Health Plan **Location** ... This position ensures that the necessary information is gathered for timely and accurate utilization review and that requests for care or services are processed… more
- Hunterdon Health Care System (Flemington, NJ)
- This is an in-person role. Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure ... an applicable health insurance plan. Primary Position Responsibilities 1. Performs utilization activities, using Milliman Care Guidelines under the guidance of the… more
- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …for a UR Specialist to provide Per Diem coverage. Job Description: The Utilization Review Specialist is responsible for monitoring adherence to the ... hospital's utilization review plan to ensure the effective...with government agencies including HIPAA requirements. + Submits discharge clinical as required by payers. + Upholds the Organization's… more
- Hackensack Meridian Health (Hackensack, NJ)
- **The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and transitions… more
- Medical Center Hospital (Odessa, TX)
- + Position Summary: The Utilization Review Specialist /Outcomes Specialist conducts concurrent and retrospective review functions in support of the ... hospital Utilization Review Program and makes appropriate referrals to designated Physician...Licensed Vocational Nurse. B. Training and Experience: Three years clinical nursing experience in general medical/surgical setting or appropriate… more
- WestCare Foundation (Henderson, NV)
- …LPN or RN and/or Bachelors or Masters level CADC/LADC with 2 years utilization review experience, preferred experience working with individuals with psychiatric ... Description Position Summary: Person in this position is responsible for collecting clinical information and communicating with MCOs in a timely manner in order… more
- AnMed Health (Anderson, SC)
- … clinical knowledge to independently review the medical record for clinical appropriateness and resource utilization including but not limited to : ... review , continued stay/concurrent review , retrospective review , bed status management, resource utilization management,...patient acuity and related clinical services, applies approved medical necessity criteria for screening… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay.… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.This is a full-time role and will be required to work ... this position: *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include… more
