- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** **The Utilization Review Physician collaborates with the healthcare team in the** **management and resolution of activities that assure the ... population and Hackensack UMC. These include but are not limited to utilization review ,** **hospital reimbursement, clinical compliance, case management, and… more
- The County of Los Angeles (Los Angeles, CA)
- …Organization guidelines and the Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...$176,872.80 Annually Location Los Angeles County, CA Job Type Full time Job Number Y5126D Department HEALTH SERVICES Opening… more
- Henry Ford Health System (Detroit, MI)
- …practicing as a physician . + Previous experience as Director of Utilization Review or Physician Advisor preferred. CERTIFICATIONS/LICENSURES REQUIRED: + ... The Medical Director of Utilization Review is responsible for the...a timely manner 9. Code 44s - UM committee physician concurrent statement. CMS Conditions of Participation 10. Lead… more
- Emory Healthcare/Emory University (Atlanta, GA)
- … Utilization Preceptor** responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN Preceptor must be an expert ... in the utilization review functions and able to cover...Location** _Atlanta, GA, 30308_ **Campus Location** _US-GA-Atlanta_ **Department** _EHM Utilization Review_ **Job Type** _Regular Full -Time_ **Job… more
- Mount Sinai Health System (New York, NY)
- …Admission Specialist (OR Scheduler), Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The Utilization Review Specialist coordinates ... testing and operating roaom time. 7. Checks credentials system for physician 's delineation of privileges for equipment and/or procedures according to medical… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …resources and benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and promoting ... planners regarding transition to alternative levels of care. + Perform concurrent utilization review applying identified criteria at prescribed review … more
- Stanford Health Care (Palo Alto, CA)
- …records to ensure the necessity and appropriateness of care provided. 3. Utilization Review : Conduct thorough utilization reviews, applying evidence-based ... and utilization management principles. + Experience in case management, utilization review , or related healthcare roles. + Strong clinical assessment… more
- Trinity Health (Silver Spring, MD)
- …Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review , under the supervision and in collaboration with the ... Manages the activities of hospital staff in inpatient care coordination and utilization review . Oversees interactions of staff with outside activities and… more
- Baptist Memorial (Jackson, MS)
- Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed ... by utilization review standards. The UR Nurse works...necessity or other areas when indicated + Communicates with physician advisors related to status concerns or denials +… more
- Providence (Mission Hills, CA)
- **Description** Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records ... strong clinical background combined with well-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination. The … more
- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …leadership, teamwork, and communication skills. ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical records ... of candidates. Education Associates Degree preferred Minimum Work Experience Utilization Review experience preferably in a behavioral/psychiatric healthcare… more
- Trinity Health (Boise, ID)
- …level reviews for patients not meeting inpatient criteria. C. Participates in local Utilization Review Committee and be a member of appropriate committees and ... **Work Experience** **Job Description:** Saint Alphonsus is seeking a physician leader to become our Medical Director of Documentation...accurate reporting of bed status. F. Assist case managers, utilization review nurses and social workers to… more
- Beth Israel Lahey Health (Burlington, MA)
- …and amounts at any time. **Job Description:** In conjunction with the admitting/attending physician , the Utilization Review RN assists in determining the ... **Job Type:** Regular **Time Type:** Full time **Work Shift:** Day (United States of...up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing… more
- Hackensack Meridian Health (Holmdel, NJ)
- …**Hackensack Meridian** **_Health_** includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team...appropriate records as required by payer agencies and initiates physician advisor's review as necessary for unwarranted… more
- Hackensack Meridian Health (Holmdel, NJ)
- …at Hackensack Meridian _Health_ includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team...appropriate records as required by payer agencies and initiates physician advisor's review as necessary for unwarranted… more
- HCA Healthcare (Campbell, CA)
- …to five years of experience in Managed Care, Provider Office, or Utilization Review organization required Physician Services Group ... Health Assistance Fund that offers free employee-only coverage to full -time and part-time colleagues based on income. Learn more...personal growth, we encourage you to apply for our Utilization Management RN opening. We promptly review … more
- Cleveland Clinic (Vero Beach, FL)
- …patient's hospital stay or visit. Some of the responsibilities of a Utilization Management Specialist include medical record review , providing clinical ... the UM Team Manager, this individual performs UM activities which includes admission review , concurrent review , retrospective chart review and clinical… 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: 11724 Salary Range: $88,854.00 (Min.)...net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- AdventHealth (Orlando, FL)
- …reviews within 24 hours of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines, on a continuing basis. + ... while understanding that **together** we are even better. **Schedule:** Full Time Remote, Applicant must live within a 50-mile...the UM nurse is responsible for escalation to the Physician Advisor or designated leader for additional review… more
- UNC Health Care (Hendersonville, NC)
- … reviews in accordance with federal regulations and the health system's Utilization Review Plan. Responsibilities: * Uses approved criteria and conducts ... the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review … more