- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …UR Specialist to provide Per Diem coverage. Job Description: The Utilization Review Specialist is responsible for monitoring adherence to the ... hospital's utilization review plan to ensure the effective...experience. + 2-3 years experience working as a UR Specialist , Medical Billing or health care quality assurance. +… more
- Hackensack Meridian Health (Hackensack, NJ)
- **The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... population and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- WestCare Foundation (Henderson, NV)
- …LPN or RN and/or Bachelors or Masters level CADC/LADC with 2 years utilization review experience, preferred experience working with individuals with psychiatric ... is performed primarily in a professional, office setting. + A minimum of 40 hours per week are expected but significantly more hours may be required from time to… more
- AnMed Health (Anderson, SC)
- …necessity review , continued stay/concurrent review , retrospective review , bed status management, resource utilization management, regulatory compliance, ... assigned utilization management functions daily: initial, concurrent and retrospective review of the medical record with speed and accuracy for all required… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay.… more
- UnityPoint Health (Cedar Rapids, IA)
- …174223 Overview This position is on site at St. Luke's Hospital. The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments ... + Area of Interest: Patient Care + FTE/Hours per pay period: 1.0 + Department: Adolescent Treatmt/Child...clinical outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management function for… more
- UNC Health Care (Kinston, NC)
- …support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying established ... dollars and appeal win rates. 12. Assists in documentation review in the clinical documentation specialist role...experience as a Registered Nurse required. + 2 years utilization review , care management, or compliance experience… more
- State of Michigan (Lansing, MI)
- …program. To identify psychotropic medication regimens that require additional physician review according to policy, the Utilization Reviewer actively monitors ... review . This position collaborates with the FC-PMOU Outreach Analyst and Data Specialist to gather data, prepare utilization reports, and then develops and… more
- Houston Methodist (Sugar Land, TX)
- …Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management and ... Seven years clinical nursing/patient care experience which includes three years in utilization review , case management or equivalent revenue cycle clinical role… more
- Nuvance Health (Danbury, CT)
- …the time of review . If unable to resolve, escalate to the PA and Utilization Review (UR) Leadership. * Coordinate with the care team in changing patient ... *Description* * PER DIEM** * *Summary:* The purpose of the...to internal leadership for assistance in resolution. *Responsibilities:* * Review all inpatient admission and observation cases using InterQual,… more
- New York State Civil Service (Albany, NY)
- …or improve children's intensive outpatient community based mental health services. Review data reports, such as utilization rates, patient characteristics, ... working with children and/or adolescents with mental illness, as well as utilization management experience, including familiarity with the review of medical… more
- State of Michigan (MI)
- Process Automation Specialist / Departmental Specialist 13 Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5156266) Apply Process ... Automation Specialist / Departmental Specialist 13 Salary $31.99 - $47.75 Hourly Location Various,...MSHDA business areas can effectively navigate the implementation and utilization of these tools while aligning with security protocols,… more
- New York State Civil Service (Albany, NY)
- …adolescents with mental illness in a clinical capacity, as well as experience with utilization management and/or utilization review . ? The ideal candidate(s) ... Agency Mental Health, Office of Title Mental Health Program Specialist 2, Central Office; Occupational Category Other Professional Careers...will have direct care and utilization management experience, including familiarity with the … more
- State of Colorado (Denver, CO)
- HCBS Benefits Specialist Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5155072) Apply HCBS Benefits Specialist Salary $71,544.00 - ... for overtime compensation. Department Contact Information Sarah Roman, Talent Acquisition Specialist ~ ###@state.co.us How To Apply Please submit an online… more
- HCA Healthcare (Asheville, NC)
- …and personal growth, we encourage you to apply for our Provider Solutions Specialist opening. We promptly review all applications. Highly qualified candidates ... We care like family! Jump-start your career as a Provider Solutions Specialist today with Mission Hospital. **Benefits** Mission Hospital offers a total rewards… more
- New York State Civil Service (Brooklyn, NY)
- …Agency Mental Health, Office of Title Mental Hygiene Program Evaluation Specialist 3 (NY HELPS), Kingsboro Psychiatric Center, P26689 Occupational Category Health ... Class Non-competitive Class Travel Percentage 0% Workweek Mon-Fri Hours Per Week 40 Workday From 6 AM To 6...Center is currently recruiting a Mental Hygiene Program Evaluation Specialist 3 to join their program evaluation department which… more
- City of Durham (Durham, NC)
- …coverage policies (NC Service Definitions, ie ACT, CST IOP, SACOT, Innovation Wavier), utilization review , and data management. + Knowledge of: + the signs ... Street Outreach Specialist Print (https://www.governmentjobs.com/careers/durhamnc/jobs/newprint/4923157) Apply Street Outreach ...Service Definitions, ie ACT, CST IOP, SACOT, Innovation Wavier), utilization review , and data management? + No… more
- Abbott (Plano, TX)
- …insurance, Worker's Compensation and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review . Some experience in medical device or DME ... currently has an opportunity for a **Patient Therapy Access Specialist ** (PTA). This is an in office 5 days...Compensation and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review . + Experience in medical device… more
- State of Colorado (CO)
- …conditions, veterans, youth, and persons experiencing long-term homelessness with frequent utilization of public systems. Campus Programs Specialist The Campus ... DOLA Campus Program Specialist (Community & Economic Development III) - Term...Programs + Paid Life Insurance + 11 paid Holidays per year plus Vacation and Sick Leave (https://dhr.colorado.gov/state-employees/time-off-leave) +… more
- New York State Civil Service (Buffalo, NY)
- …Yes Agency Mental Health, Office of Title Mental Hygiene Program Evaluation Specialist 3, (NY HELPS), Buffalo Psychiatric Center, P27411 Occupational Category Health ... Class Competitive Class Travel Percentage 0% Workweek Mon-Fri Hours Per Week 40 Workday From 6 AM To 6...14213 Duties Description As a Mental Hygiene Program Evaluation Specialist 3, your duties include:* Collecting and analyzing data… more