- 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
- 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
- Henry Ford Health System (Troy, MI)
- …quality of care provided by the primary care team. He/she works with utilization management reports, corporate data stores, and information services to optimize ... waste, and rework in the region, and improve drug utilization . The Pharmacy Specialist will be instrumental...on their health journey, Henry Ford Health provides a full continuum of services at 250 care locations throughout… 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
- Henry Ford Health System (Troy, MI)
- …case information to payers as needed. * Maintain a current knowledge of Utilization Management through interaction with staff and payor portal representatives. * ... shifts between 7:30am and 6:00pm GENERAL SUMMARY: The support specialist is a support role crucial to the centralized... is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and… 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
- BayCare Health System (Winter Haven, FL)
- …Employer Veterans/Disabled **Position** Utilization Review Specialist Senior **Location** Winter Haven:Winter Haven | Clinical | Full Time **Req ID** null ... foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions… 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
- Providence (WA)
- …best people, we must empower them._** **Providence Health Plan is calling an Associate Utilization Review Specialist who will:** + Be responsible for all core ... **Requsition ID:** 293782 **Company:** Providence Jobs **Job Category:** Health Information Management **Job Function:** Revenue Cycle **Job Schedule:** Full … more
