- Butterball (Carthage, MO)
- …maintaining safety culture and ensuring continuous improvement through the utilization of Butterball Operating System Solutions (BOSS). Supports and empowers ... to our commitments and take responsibility for the well-being of our teams, our quality , our customers, our business, our brand, and our communities. We are always… more
- Elliot Health System (Bedford, NH)
- …priorities for improvement. Identifies and collects clinical data in support of quality , risk management , utilization , infection control and resource ... emotional support to patient/family to facilitate adaptation to illness/disability. Utilization Management /Managed CareIntervenes with appropriate individuals/department regarding… more
- WMCHealth (Valhalla, NY)
- …class assists in the implementation or investigation of the procedures specified in the Quality Management , Utilization Review and Discharge Planning ... one of which must have been in the area of utilization review , quality assurance, risk management or discharge planning. About Us: Westchester Medical… more
- Community Health Systems (Franklin, TN)
- …Advisor provides clinical expertise and guidance to support case management , utilization review , and quality improvement initiatives across the ... regarding case management practices, payer guidelines, and utilization review protocols. + Performs other duties...+ 2-4 years of experience in utilization management , case management , or quality … more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... proud to be a trusted healthcare provider, offering personalized, high- quality care to the South Shore of Massachusetts. As...and Serve Your Community!** **In your role as a Utilization Review & Denials Management … more
- Sutter Health (Sacramento, CA)
- …Advisor will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to ... case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Some awareness… more
- Matrix Providers (Aurora, CO)
- …Care Quality and Management (HCQM) through American Board of Quality Assurance and Utilization Review Physicians (ABQARP) + Certified Informatics ... the American Nurses Credentialing Center + Utilization Management Accreditation through National Committee for Quality ...care clinical setting and 12 months consecutive experience in utilization management , utilization review… more
- Intermountain Health (Las Vegas, NV)
- …**Job Profile:** Performs medical review activities pertaining to utilization review , claims review , quality assurance, and medical review ... + Demonstrated timely documentation and reporting. + Demonstrated knowledge of case management , utilization management , quality management , discharge… more
- Beth Israel Lahey Health (Burlington, MA)
- …Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey Clinic ... to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management ...needed. 10) Supports all service line activities related to utilization and quality management . 11)… more
- Emanate Health (Covina, CA)
- …Education Requirement:** **Minimum Experience Requirement:** Minimum of three years of utilization management experience. Experience in quality - related ... #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records...keep well in body, mind and spirit by providing quality health care services in a safe, compassionate environment.… more
- Behavioral Center of Michigan (Warren, MI)
- Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination, implementation and reporting of complex ... clinical data and supports the operations of Samaritan Behavioral Center. The Utilization Review Coordinator reviews the patient's chart and records clinical… more
- Stanford Health Care (Palo Alto, CA)
- …Skills and Abilities** + Knowledge of principles and best practices of case management , utilization review , social work, care coordination and discharge ... practice. Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation,… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more
- Dignity Health (Phoenix, AZ)
- …and commercial admission and review requirements + In-depth knowledge of utilization management processes and best practices + Strong managerial and ... and Nevada markets. Must have current Arizona unrestricted RN license.** The Utilization Management (UM) Manager is responsible for managing day-to-day UM… more
- CenterLight Health System (NY)
- …of experience in care/case management , disease management , population health management , utilization review , quality assurance, or discharge ... escalate issues of changes to ensure proper care and management of cases are followed. + Promotes and educates...Escalates questions or concerns during the assessment to the quality review team to ensure appropriate completion… more
- Intermountain Health (Murray, UT)
- …regulatory requirements. + Occasional travel to provider locations within Select Health region. ** Utilization Review and Care Management :** + ** Review ... This role is essential in ensuring that members receive high- quality , cost-effective care. The ideal candidate will possess a...experience in Autism and working with Autistic Clients. + Utilization Review and Care Management … more
- Independent Health (Buffalo, NY)
- …and Accountable. **Essential Accountabilities** Provide High Quality , Professional Utilization Management Services: (Medical necessity review for ... benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Utilization Review Nurse (URN) performs clinical review to… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …clinical expertise with knowledge of medical appropriateness criteria, and applies principles of utilization and quality management , and the management ... resources as a facilitator and consultant to the multidisciplinary patient care team. The Utilization Review Nurse is responsible for review of clinical… more
- Ochsner Health (New Orleans, LA)
- …the Interdisciplinary and Post-Acute teams, Payors, Administration and Revenue Cycle) to improve utilization management , sustain quality goals, and act as a ... or (2) Board Certification by the American Board of Quality Assurance and Utilization Review ... quality , cost-effective, efficient patient care services + Utilization Management experience (preferred) + Familiarity with:… more
- US Tech Solutions (Chicago, IL)
- …MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE...with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an… more
