- Spectrum Billing Solutions (Skokie, IL)
- …Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management ... Specialist | Insurance Specialist | UR Specialist | Revenue Cycle Utilization Review Specialist | ABA Utilization Review Specialist |… more
- Amergis (Westborough, MA)
- Utilization Review Specialist Job Summary The Utilization Review Specialist isresponsible for monitoring adherence to the hospital's ... utilization review planto ensure the effective and efficient use of hospital services. Monitors theappropriateness of hospital admissions and extended hospitals… more
- Kelsey-Seybold Clinic (Pearland, TX)
- **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews, benefit verification, and applying criteria to ... services requiring authorization prior to services being rendered for members. The Utilization Review Specialist (LVN) serves as a liaison in reviewing… 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
- 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 ... patient population and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- BayCare Health System (Cotton Plant, AR)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding ... and compassionate team. **The Utilization Review Specialist Senior responsibilities include:** + Functions as the primary liaison between the funding agents… more
- BayCare Health System (St. Petersburg, FL)
- …a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + ... Critical Care or Emergency Service Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Specialist Senior **Location** St… more
- Spectrum Billing Solutions (Skokie, IL)
- …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR ... admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for… 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 care that may be covered. + Monitors all utilization reports to assure compliance with reporting and turnaround… more
- Fairview Health Services (St. Paul, MN)
- …meets regulatory requirements. Participates in interdisciplinary communication related to utilization review issues. Educates on status. Provides all ... M Health Fairview has an immediate opening for a Utilization Management Specialist RN. This position provides...+ Current RN licensure in MN + 3-5 years utilization review or case management experience in… more
- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …Time + Employee Discount Program + Employee Assistance Program Job Description: The Utilization Review Specialist is responsible for monitoring adherence to ... Westborough Behavioral Healthcare Hospital is looking for a UR Specialist to provide Per Diem coverage. Benefits Include +...the hospital's utilization review plan to ensure the effective… more
- Truman Medical Centers (Kansas City, MO)
- …into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Specialist 101 Truman Medical Center **Job ... coaching and consulting to outside organizations. **Job Description** The Utilization Specialist can be the first point...work with FCC Staff for all self-pay patients to review eligibility for the University Health Discount and/or Medicaid.… more
- The 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 (OR Scheduler),… more
- Access Dubuque (Dubuque, IA)
- …of information and consent for treatment from the client and/or guardian + Review utilization dashboards and/or internal client referral information to ensure ... Admissions/ Utilization Management Specialist **Hillcrest Family Services** 1 Positions ID: 143341 Posted On 08/07/2024 **Job Overview** **Your Responsibilities**… 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: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve… more
- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. The Utilization Management (UM) Specialist is responsible for applying clinical and ... authorizations to requests from CCA Clinicians, Vendors and Providers. The UM Specialist reports to the Utilization Management Nurse Manager. **What You'll… more
- AmeriHealth Caritas (Newtown Square, PA)
- ** Utilization Management Administrative & Operations Program Specialist ** Location: Newtown Square, PA Primary Job Function: Medical Management ID**: 34417 Y ... about us at www.amerihealthcaritas.com. **Responsibilities:** As part of the Utilization Management Administrative team, the UM Administrative and Operations Program… more
- The Mount Sinai Health System (New York, NY)
- …of services **RESPONSIBILITIES** Responsible for all aspects of the concurrent review program, insurance certification, and authorization process for all Psychiatric ... by management) and for all aspects of the initial review on an as needed basis Develops rapport with...providers as well as regulatory agencies, as needed for Utilization Management activities Demonstrates the knowledge and skills necessary… more
- Huron Consulting Group (Chicago, IL)
- …as the expert you are now and create your future. **Qualifications** The Utilization Management Specialist is responsible for ensuring the appropriate ... to facilitate optimal patient outcomes while managing healthcare costs. The Utilization Management Specialist ensures compliance with regulatory requirements and… more
- Trinity Health (Pontiac, MI)
- …RN licensure within the State of Michigan. Certified Professional in Utilization Review /Management preferred. **C** **Special Skill / Aptitudes** Understanding ... care utilization management experience. Knowledge of regulations relative to utilization review . Knowledge of Federal, State and Local regulations sources.… more