- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Specialist 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
- HonorHealth (Scottsdale, AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… 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...documented in the case management system by the UR Review Specialist . + In the event a… more
- Sutter Health (Berkeley, CA)
- …and others to ensure appropriate utilization and quality care through utilization review , tracking and evaluation and objectively compare criteria with ... clinical nursing staff and other departments regarding documentation required for utilization review activities and processes. Collaborate with medical, nursing… more
- Trinity Health (Maywood, IL)
- …is Loyola campus. Position is hybrid, must reside in Illinois. The **Regional Utilization Review Documentation Specialist ** nurse works with the ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Utilization Review - RN Reviewer- Regional Coverage for Loyola, Gottlieb and MacNeal… more
- Mount Sinai Health System (New York, NY)
- …Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The Utilization Review Specialist coordinates scheduling of all surgical/endoscopic ... **Job Description** ** Utilization Review Admission Specialist ...funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical… more
- ManpowerGroup (Meridian, ID)
- …align successfully within the organization. **Job Title:** Utilization Management Specialist **Location:** Meridian, ID **Pay Range:** $25.27 per hour ... Our client, a leader in the healthcare industry, is seeking an Utilization Management Specialist to join their team. The ideal candidate will have strong… more
- Fairview Health Services (St. Paul, MN)
- …meets regulatory requirements + Participates in interdisciplinary communication related to utilization review issues. + Educates on status. + Eliminates ... Management Supervisor. This is a 1.0 FTE (80 hours per two week pay period), salaried/exempt role. This position...clinical knowledge to work with facilities and providers for utilization review . Works with medical directors in… more
- Katmai (Usaf Academy, CO)
- …for inpatient/outpatient precertification. **ESSENTIAL DUTIES &** **RESPONSIBILITIES** + Review precertification requests for medical necessity, referring to the ... Medical Director those that require additional expertise. + Review clinical information for concurrent reviews. + As part...Minimum of two (2) years of prior experience in Utilization Management. + Must possess a current, active, full,… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Surgical Review Specialist prospectively reviews, validates, and audits procedure code assignment ... lost with feedback to respective departments + Conduct concurrent review with utilization review department...AND SENSORY DEMANDS: Sitting for up to 7 hours per day, 3 hours at a time. Repetitive arm/finger… more
- Stony Brook University (Stony Brook, NY)
- Per Diem - Behavioral Health Specialist **Position Summary** At Stony Brook Medicine, our Behavioral Health Specialist : + Orients patients to treatment ... interventions, restraint/seclusion, behavior plan development and safety plan development, utilization and monitoring. + Conducts a variety of patient treatment… more
- Trinity Health (Albany, NY)
- …that result from the clinical utilization reviews with the facilities Per Diem- Insurance Specialist to assist with authorizations for Substance abuse ... college level course in medical terminology. + One year of case management or utilization review /billing or coding experience. + One year of experience in… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and tracks ... experimental, coding or other issues that may require record review . Provides billing with information needed to obtain payment...SENSORY REQUIREMENTS: Requires sitting for up to 4 hours per day, 2 hours at a time. Standing for… more
- Dartmouth Health (Lebanon, NH)
- …capacity analysis. * Analyzes inventory/product data, utilizing customized query utilization reports and formulates recommendations for adjustments as necessary to ... and positive financial outcomes * Meets with department managers or directors to review PAR statistical data and makes recommendations for adjustments which meet the… more
- MetroLink (Los Angeles, CA)
- Finance Specialist I, Grants Finance (Limited Term) Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4709470) Apply Finance Specialist I, ... the Metrolink passenger rail service, is seeking a Finance Specialist I who will perform a wide variety of...forwarded to the hiring authority for consideration. The first review of applications begins January 13, 2025. Interested applicants… more
- Medical Mutual of Ohio (OH)
- …area of billing and coding, medical records, quality assurance, or utilization review .** **Professional Certification(s):** **.** **Medical Technology or Health ... **_The Medical Record Retrieval Specialist position allows you the flexibility to work...of billing and coding, medical records, quality assurance or utilization review , at least 2 years of… more
- Great River Health (West Burlington, IA)
- …related field, preferred Clinical Documentation Improvement experience preferred Case management/ utilization review experience preferred Proficiency in computer ... data and analysis systems preferred Microsoft Office product experience preferred Benefits: We are excited to offer an aggressive compensation and benefits package for qualifying positions, which includes: + Competitive base pay + Matching retirement programs… more
- Veterans Affairs, Veterans Health Administration (Fayetteville, NC)
- …severity of illness, risk of mortality, complexity of care, and utilization of resources. Identifies opportunities for documentation improvement by ensuring that ... and completeness of clinical documentation. Inpatient CDI focuses on the concurrent review of patient records with an emphasis on improving documentation while the… more
- Colonial Pipeline Company (Alpharetta, GA)
- …Maintenance Specialist ensures field maintenance alignment with Planning & Utilization goals and liaisons with other departments as needed to support planned ... United States, transporting more than 100 million gallons or 2.5 million barrels per day. Colonial transports various grades of gasoline, diesel fuel, home heating… more
- MyFlorida (Fort Myers, FL)
- …62-6 Florida Administrative Code, and the Environmental Health Program Manual 150-4. The specialist will review applications and plans and accept and issue ... ENVIRONMENTAL SPECIALIST III - 64006643 Date: Feb 11, 2025...sanitary nuisances and overcrowding, to prevent environmentally transmitted diseases per Ch. 381.006 (14) FS, Ch. 513 FS, and… more