- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Utilization Review Quality Assurance Coordinator is responsible for all compliance related paperwork and ensures paperwork is completed ... Monitor open encounters and report any issues to the Business Manager. Review utilization of services in order to comply with regulatory and institutional… more
- Intermountain Health (Las Vegas, NV)
- …medical review activities pertaining to utilization review , claims review , quality assurance , and medical review of complex, controversial, ... to utilization management. + Demonstrated knowledge of case management, utilization management, quality management, discharge planning, and other cost… more
- LifePoint Health (Wilson, NC)
- …Science or related associate healthcare degree and a minimum of 2 years' experience in utilization review / quality assurance work. Registration as an RHIT ... using criteria as determined by current department procedures and recommendations from Utilization Review Committee Severity to determine the medical necessity… more
- Beth Israel Lahey Health (Burlington, MA)
- …coordinates utilization review , discharge planning and monitors quality assurance for Lahey Clinic inpatient admissions. Leads the multidisciplinary ... States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full...needed. 10) Supports all service line activities related to utilization and quality management. 11) Assists in… more
- Ellis Medicine (Schenectady, NY)
- …Participates in credentialing data and system. * Ensures the comprehensive integration of Utilization Review , Quality Assurance , and Discharge Planning ... as a RN in New York State. Experience: Previous Utilization Review , Quality Assessment, Discharge...to plan best management plan. * Ensures effective concurrent Quality Assurance . Works closely with chiefs/QA process,… more
- Centene Corporation (Springfield, IL)
- … quality improvement activities. + Performs medical review activities pertaining to utilization review , quality assurance , and medical review ... + Provides medical expertise in the operation of approved quality improvement and utilization management programs in...with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends… more
- Centene Corporation (Austin, TX)
- … quality improvement activities. Performs medical review activities pertaining to utilization review , quality assurance , and medical review ... of physician education with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends in utilization … more
- Stanford Health Care (Palo Alto, CA)
- …management, including the principles and practices of discharge planning, utilization review , and quality assurance /improvement + Knowledge of the ... responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient… more
- MTC (Bryan, TX)
- … Assurance Coordinator:** 1. Performs complex technical assistance work; implements quality assurance utilization review procedures; and responds ... and an employee wellness program. **MTC is now hiring for a full-time Quality Assurance Coordinator at the JW Hamilton Unit located in Bryan, TX.** **What you'll… more
- HCA Healthcare (El Paso, TX)
- …experience. Working knowledge of case management philosophy/process/role, needs assessment, principles of utilization review / quality assurance , use of ... review agencies including governmental and non-governmental payers and quality assurance agencies. Promotes a cooperative and supportive relationship… more
- HCA Healthcare (El Paso, TX)
- …experience. Working knowledge of case management philosophy/process/role, needs assessment, principles of utilization review / quality assurance , use of ... review agencies including governmental and non-governmental payers and quality assurance agencies. Promotes a cooperative and supportive relationship… more
- WMCHealth (Poughkeepsie, NY)
- …either a hospital, health care agency or managed care company in the area of utilization review , quality assurance , risk management or discharge ... by implementation or investigation of the procedures in the Utilization Review and Discharge Planning program at...Health and Det Norske Veritas (DNV) standards; ability to review , analyze and investigate Quality Assurance… more
- MTC (Breckenridge, TX)
- …productive life. **Essential Duties:** 1. Performs complex technical assistance work; implements quality assurance utilization review procedures; and ... policies, and procedures. 2. Assists in monitoring, reviewing, interpreting, and evaluating quality of services and success of programs; assists in compiling and… more
- University of Maryland, Baltimore (Baltimore, MD)
- …Directs activities related to the delivery of medical care and clinical services such utilization review , quality assurance , policies, procedures and ... operational, and leadership skills and experience in neonatal care, quality , and safety to lead the clinical service. The...clinical and reimbursement activity. 7. Participates in the Peer Review Program as described in the Medical Staff Bylaws… more
- Amergis (Newington, CT)
- …information, and referrals for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers ... continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical regime. Essential… more
- Ventura County (Ventura, CA)
- …+ Selects, trains, supervises and conducts performance management for quality assurance and utilization review staff; + Supervises collection and ... Behavioral Health Quality Assurance Manager Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4484664) Apply Behavioral Health Quality … more
- CenterLight Health System (NY)
- …(5+) years of experience in care/case management, disease management, population health management, utilization review , quality assurance , or discharge ... model. + Escalates questions or concerns during the assessment to the quality review team to ensure appropriate completion of UAS-NY and handling of on-site… more
- Sevita (Dedham, MA)
- …coverage system. + May develop and implement crisis intervention emergency procedures, oversee Utilization Review , Quality Assurance , investigations, and ... oversee counselors, psychological services, and service plans to ensure quality psychological evaluations and services for company program participants; proactively… more
- FlexStaff (New York, NY)
- …(5+) years of experience in care/case management, disease management, population health management, utilization review , quality assurance or discharge ... clinical onboarding and reassessment, UAS-NY completion, comprehensive assessment, medication review , and post-hospital discharge evaluation. An ideal candidate would… more
- Nuvance Health (Newtown, CT)
- …to the delivery of medical care and clinical services such as cost management, utilization review , quality assurance , and medical protocol development ... all our hospitals and sites. The medical director is responsible for driving quality of care, optimizing patient access and ensuring top decile patient experience… more