- Daiichi Sankyo, Inc. (Bernards, NJ)
- …pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science and ... areas centered around rare diseases and immune disorders. Job Summary: The Director of Data Management (DM) Reporting provides leadership in Data Management… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …(MedDRA and WHO Drug Coding dictionaries) including dictionary support documentation . Collaborates cross-functionally with the Medical , Clinical Development, ... for assigned studies and escalates issues to the Associate Director of Medical Coding to gain resolution....data and adherence to regulatory requirements. Develops and maintains documentation of items on medical coding, including… more
- Trinity Health (Boise, ID)
- …Saint Alphonsus is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This position will be ... annually by the Saint Alphonsus Chief Clinical Officer. The Medical Director of Documentation and Utilization Excellence (MDDUE) is the lead provider for… more
- AnMed Health (Anderson, SC)
- The Utilization Review Medical Director supports operations and direction of the Care Coordination, Clinical Documentation , and Utilization ... Management programs at AnMed. The Medical Director ensures the program and associated physicians work collaboratively with and provide consultation to the… more
- Ochsner Health (New Orleans, LA)
- …and comply with Federal and State regulations/quality initiatives. Reports to the System Medical Director of Utilization . This job description is a ... & support education needs of the medical staff with regard to documentation , placement and utilization of resources _Other duties as assigned_ +… more
- University of Utah Health (South Salt Lake, UT)
- …clinical review. + Reviews patient chart to ensure patient continues to meet medical necessity. + Documentation of all actions and information shared with ... organization through the provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such care; achieved via managing… more
- BayCare Health System (Tampa, FL)
- …with organizational initiatives and priorities. + Reports directly to the Physician Advisor Medical Director . + Performs active and timely review of observation ... + Completes Cerner Secondary Reviews in a timely fashion with appropriate documentation allowing Utilization Review Nurses to efficiently execute Secondary… more
- Community Health Systems (Franklin, TN)
- …and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for admission to ... for hospitalized patients. + Hold collaborative discussions with physicians on the medical staff, when needed, to obtain additional documentation in the… more
- Equinox, Inc (Albany, NY)
- …including admissions, discharges, and residential waitlist updates. Use the Evolv Medical Record System to track client documentation , including entering ... Intake & Utilization Coordinator - Adult Residential Services Albany, NY...clients. This position requires ensuring clients have the correct documentation to secure active housing waitlist status, maintaining accurate… more
- Sharp HealthCare (San Diego, CA)
- …Care Coordinator level of review.Appropriately identify claims for review by the Medical Director to include obtaining the appropriate medically necessary ... the eMD for and forward the claim with all applicable information to the Medical Director . + Quality and Productivity Performance Achieve 90% or greater… more
- Ascension Health (Baltimore, MD)
- …and implement quality review programs and key performance indicators for all utilization review activities. + Interact with medical , nursing, and executive ... **Details** + **Department:** Utilization Management + **Schedule:** On-site, Monday-Friday, 8:00AM-4:30PM. Must be available as needed to address urgent or… more
- Community Health Systems (Naples, FL)
- **Onsite Role **Comprehensive Benefits **Job Summary** Under the direction of the Utilization Review (UR) Director /Manager the Utilization Review (UR) Nurse ... on performance improvement of the UR KPI's. Ensures proper and accurate medical record documentation . **Essential Functions** + Reviews new admissions using… more
- Dignity Health (Glendale, CA)
- …be responsible for a variety of tasks including daily review of all necessary Medical records for appropriate documentation as it relates to acuity/charges and ... CPT level description, reconcile medical record log, and provide ongoing feedback to the...with DH affiliated IPA's to discuss opportunities around patient utilization + Provide daily/weekly/monthly OON reports/updates to Director… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** The Director of Clinical Documentation Integrity impacts all acute care ... which generate $60M to $85M of revenue annually by ensuring documentation accurately reflects the patient's condition. This individual provides strategic leadership… more
- UPMC (Hanover, PA)
- **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a rotating ... the clinical and financial plan for patients. Performs overall utilization management, resource management, discharge planning and post-acute care referrals… more
- Veterans Affairs, Veterans Health Administration (San Juan, PR)
- Summary The Utilization Management Nurse (UMN) serves as a subject matter expert in the clinical criteria at the facility level and conducts clinical reviews of ... and creative approaches to management of patient care. Responsibilities The Utilization Management Nurse (UMN) demonstrates expertise in the professional practice by… more
- Houston Behavioral Healthcare Hospital (Houston, TX)
- …currently has an opening for Full-time Utilization Management Coordinator. The Utilization Management Coordinator will report to the Director of ... discharge planning for patients. + Conducts reviews and other communications and documentation as required by payor standards to obtain necessary certification to… more
- HonorHealth (Scottsdale, AZ)
- …area. The comprehensive network encompasses nine acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer ... care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, community services and more. With… more
- US Tech Solutions (Columbia, SC)
- …back up review determinations. Identifies and makes referrals to appropriate staff ( Medical Director , Case Manager, Preventive Services, Subrogation, Quality of ... accurate documentation of clinical information to support and determine medical necessity criteria and contract benefits. Collaborates with Care Management and… more
- Katmai (Usaf Academy, CO)
- …+ Review precertification requests for medical necessity, referring to the Medical Director those that require additional expertise. + Review clinical ... for assuring the receipt of high quality, cost efficient medical outcomes for those enrollees identified as having the...Minimum of two (2) years of prior experience in Utilization Management. + Must possess a current, active, full,… more
