- Robert Half Accountemps (Lauderdale Lakes, FL)
- Description We are offering a contract for a Utilization Review ( UR ) Records Analyst (ABA) position in Lauderdale Lakes, Florida. This role is primarily ... * Familiarize yourself with regulatory compliance standards, payer requirements, and utilization review processes. * Work independently after training,… more
- Community Health Systems (Franklin, TN)
- …appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for ... to the hospital as well as continued stay. The Utilization Review Clinical Specialist supports and coordinates...and payer requirements. These discussions aim to help the UR Clinical Specialist understand the reason for admission and… more
- San Antonio Behavioral Health (San Antonio, TX)
- …inefficiencies or deviations from standards of care. * Maintain accurate and detailed records of utilization review activities and outcomes. * Prepare ... The Utilization Review Coordinator conducts utilization...appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with patients' treatment. Reviews… more
- Community Health Systems (Franklin, TN)
- …appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for ... documentation from the physician(s). + Escalates cases to the Utilization Review Manager and/or Physician Advisor if...and documented in the case management system by the UR Review Specialist. + In the event… more
- Desert Parkway Behavioral Healthcare Hospital (Las Vegas, NV)
- …that all days are authorized and identify denied days, coordinate with Director of Utilization Review and add to Denial Tracker when appropriate. Monitor and ... assigned to the case when completed. Appeals As directed by UR Director, retrieves patient records from EMR, prints chart, and forwards chart to staff… more
- Behavioral Center of Michigan (Warren, MI)
- …and supports the operations of Samaritan Behavioral Center. The Utilization Review Coordinator reviews the patient's chart and records clinical information ... Reviews patient recrods and evaluates patient progress. Performs continuing review on medical records and identification and...requests for appeal of denials. Responds to complaints per UR guidelines. Maintains utilization review … more
- HonorHealth (Scottsdale, AZ)
- …communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Sharp HealthCare (San Diego, CA)
- …and internal transfer requests and direct admission requests. This position supports utilization review functions to ensure appropriate patient status and ... while ensuring compliance with all local, state and federal regulations governing utilization review activities and/or care management. Expected outcomes include… more
- Sharp HealthCare (San Diego, CA)
- …Management (ICM) team the Utilization Manager (UM) II position supports utilization review functions to ensure appropriate patient status before the patient ... while ensuring compliance with all local, state and federal regulations governing utilization review activities and/or care management. Expected outcomes include… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …mental health and co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: $31.00-$49.24 PER HOUR REPORTS ... TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as... records of appeals. + Recordkeeping: Maintains appropriate records (AIS, UR forms/charts, Peer to Peer… more
- Prime Healthcare (Passaic, NJ)
- …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... accredited institution in a Health and Human Services field is highly preferred.2. Utilization Review experience is highly preferred.3. Must meet the performance… more
- Desert Parkway Behavioral Healthcare Hospital (Las Vegas, NV)
- The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties ... include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures. + Performs… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties ... include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures. + Performs… more
- Tufts Medicine (Burlington, MA)
- …personnel in the Clinical Documentation Improvement, HB/PB Coding, HIM Operations, and Utilization Review ( UR ) departments while implementing enterprise-wide ... direct standardization of activities across localized CDI, Coding, and Utilization Review departments. They will provide input...12. Ensures quality and quantity of documentation in medical records for UR . 13. Attends treatment staff… more
- Prime Healthcare (Kankakee, IL)
- …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... and completes the clinical reviews for all patient medical records while working closely with CMO (Chief Medical Officer)....PA, or Nursing Graduate required. 2. Three years of Utilization Review experience as a Medical … more
- University of Rochester (Rochester, NY)
- …any investigations and corrective action plans as it relates to HazD handling and utilization within the health system. Documents the review of the quality ... time Scheduled Weekly Hours: 40 Department: 100124 Environmental Health & Safety Work Shift: UR - Day (United States of America) Range: UR URG 111 Compensation… more
- Houston Methodist (The Woodlands, TX)
- …with the evaluation of the hospital's Utilization Management Program, including annual review and revision of the hospital's UR plan. + Contacts physicians ... resources. The Physician is a key member and leader of the hospital's utilization review /management committee, which is charged with regulatory goals of ensuring… more
- Ventura County (Ventura, CA)
- …+ Quality Management + Post-Operative Services + Public Health + Telemetry + Trauma + Utilization Review ( UR ) + None/Other 05 Please indicate the specialty ... to assure comfort and cleanliness of patients; takes and records temperature, pulse, respiration, and blood pressure, bathes, shaves,...Health + Quality Management + Telemetry + Trauma + Utilization Review ( UR ) + Other… more
- Trinity Health (Syracuse, NY)
- …12-day shifts. Emergency department experience preferred. **Position Purpose:** The Registered Nurse Utilization Review ( UR ), Clinical Care Manger (CCM) ... actively manages the utilization review process and patient progression from Admission to Discharge....collaboration with all members of the healthcare team, the UR /CCM is the principal liaison between emergency services, surgical… more
- Avera (Spencer, IA)
- …and so much more!** **Responsibilities:** + Position will include discharge planning and utilization review + Provides social services to patients and their ... quality care + Assist with the day to day utilization review activities for admission and continued...unit, and OB unit + Assist with monitoring medical records for documentation of medical necessity and discharge planning… more