- Alameda Health System (Oakland, CA)
- …each individual in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. ... utilization reviews and determine program improvements. Develop and implement utilization review policies and procedures in accordance with industry… more
- Christus Health (Texarkana, TX)
- …therapy department. Participates in medical chart peer review , case record review and utilization review as deemed necessary. Assumes responsibility ... for therapeutic equipment safety, operation and maintenance. Requirements: Education/Skills Basic Computer Knowledge Ability to communicate effectively, both verbally and written. Graduate of an accredited occupational therapy program. Experience New graduate… more
- Christus Health (Wake Village, TX)
- …and procedures manual. Participates in medical chart peer review , case records review and utilization review as deemed necessary by management. Performs ... all other duties as assigned. Requirements: Education/Skills Masters level degree in speech language pathology is required. Basic Computer Knowledge Ability to communicate effectively, both verbally and in writing. Experience New graduate entry level or any… more
- Christus Health (Leary, TX)
- …and procedures manual. Participates in medical chart peer review , case records review and utilization review as deemed necessary by management. Performs ... all other duties as assigned. Requirements: Education/Skills Masters level degree in Speech Language Pathology is required Basic computer knowledge Ability to communicate effectively, both verbally and written Experience New graduate entry level or any amount… more
- Christus Health (Red Lick, TX)
- …and procedures manual. Participates in medical chart peer review , case records review and utilization review as deemed necessary by management. Performs ... all other duties as assigned. Requirements: Education/Skills Masters level degree in speech language pathology is required. Basic Computer Knowledge Ability to communicate effectively, both verbally and in writing. Experience New graduate entry level or any… more
- Buckeye Community Health Plan (Thornville, OH)
- … management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review , quality ... of physician education with respect to clinical issues and policies. Identifies utilization review studies and evaluates adverse trends in utilization… more
- Vista Community Clinic (Vista, CA)
- …technicians and other staff. Participate in quality assurance, quality improvement and utilization review Provide in-service training to clinic staff to increase ... protocols and procedures to ensure quality medical care Participate in utilization and peer review programs which evaluates the quality of the medical staff and… more
- University Health (Hondo, TX)
- …recent, full time hospital experience preferred. Work experience in case management, utilization review , or hospital quality assurance experience is preferred. ... and clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF scores to… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …including specimen identifiers and metadata, and ICF-associated permissions prior to utilization .Collaborate with Procurement to review contracts and ensure ... qualification for biorepository vendors responsible for long-term storage.Assist the Biorepository Lead and Head of BSM as needed to manage the communication with Precision Medicine and the clinical study teams to address informed consent and IRB/EC questions… more
- University Health (San Antonio, TX)
- …recent, full-time hospital experience preferred. Work experience in case management, utilization review or hospital quality assurance experience is preferred. ... Must complete a Clinical Documentation Improvement Course within specified time of hire date. LICENSURE/CERTIFICATION Current license from the Board of Nurse Examiners of the State of Texas to practice as a registered nurse is required. National certification… more
- Trinity Health (Syracuse, NY)
- …the administrative team to oversee department activities. Manage cost management, utilization review , quality assurance, and medical protocol development. ... guidelines and assist in policy/procedure development. Oversee clinical peer review , documentation, and care planning. Assist with clinical patient complaints… more
- HCA Healthcare - Chief Medical Officer (San Antonio, TX)
- …a data-driven environment of quality and cost improvement and develops systems to review utilization of resources and objectively measure outcomes of care in ... medical staff regarding clinical resource management, appropriate documents standards, utilization and quality issues, and quality improvement activities, in… more
- Tris Pharma (Monmouth Junction, NJ)
- …other payer contracts, including redlining contract language, coordinating cross-functional review and approval workflows, and ensuring execution consistent with ... contact for IntegriChain (BPO partner), managing data file submissions, utilization reporting, rebate validation processes, and issue escalation to ensure… more
- Novo Nordisk Inc. (Minneapolis, MN)
- …providers and IHNs; c) develops appropriate use of NNI products and greater utilization of its services d) supports and assists representatives and managers in ... sites; ensuring effective coordination and facilitation of studies to ensure timely review , initiation, and completion, as well as publication of study results.… more
- Monogram Health (Jacksonville, FL)
- …suite of technology-enabled clinical services, including case and disease management, utilization management and review , and medication therapy management ... services that improve health outcomes while lowering medical costs across the healthcare continuum. By focusing on increasing access to evidence-based care pathways and addressing social determinants of health, Monogram has emerged as an industry leader in… more
- BoldAge PACE (Owensboro, KY)
- …practices and equipment use to enhance participant care. Support quality improvement, utilization review , and compliance initiatives. Perform other IDT duties as ... care coordination. Supervise Certified Occupational Therapy Assistants (COTAs), including review of care plans, co-signing documentation, and providing ongoing… more
- Rainier Springs (Vancouver, WA)
- …patient's treatment Works well with the interdisciplinary team including physicians, utilization review and nursing staff members Demonstrates active ... communication with team members Effectively communicates to UR on treatment and LOS issues Completes appropriate paperwork for clients in a timely, accurate and complete manner Demonstrates appropriate crisis intervention and de-escalation skills Acts as a… more
- Columbus Springs East (Columbus, OH)
- …with the patient's treatment Works well with the interdisciplinary team including physicians, utilization review and nursing staff members Why join us We believe ... that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers: Comprehensive Benefits Multiple levels of medical, dental and vision coverage for full-time and part-time… more
- Interim HealthCare (Greenwood, IN)
- …Nurse (RN) in home health or similar setting; previous case management/ utilization review experience preferred. OASIS experience preferred. Practical trach ... and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best is non-negotiable - that's why we treat your family like our own. We take a patient-centric approach to address each individual's mind, body, and spirit,… more
- Valley Springs Behavioral Health Hospital (Holyoke, MA)
- …closely with the interdisciplinary team-including physicians, nursing staff, and utilization review -to ensure high-quality, patient-centered care. This position ... requires accurate and timely documentation, adherence to confidentiality and regulatory standards (HIPAA, 42 CFR Part 2), and a commitment to supporting patients' emotional and behavioral health recovery in a structured, therapeutic setting. Why join us We… more
