- Alameda Health System (Oakland, CA)
- …performed by each individual in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and ... utilization reviews and determine program improvements. Develop and implement utilization review policies and procedures in accordance with industry… more
- BayCare Health System (St. Petersburg, FL)
- …on a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Team Lead Utilization Review responsibilities include:** + ... award bonus + Community discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Team Lead **Location** St… more
- Prime Healthcare (Ontario, CA)
- …actively seeking new members to join our corporate team ! Responsibilities The Utilization review lead essentially works to coordinate the utilization ... be responsible for all clerical processes in the UR team including coordinating phone calls, data entry, mailing/faxing appeals... lead will work closely with the Corporate/Facility Utilization review teams, Business Office, Case Managers,… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- …individuals with disabilities? If so, we invite you to learn more about joining our team as a Utilization Review Nurse Coordinator! The State of Connecticut ... Utilization Review Nurse Coordinator (40 Hour)... Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment #...care facilities; + May lead an inspection team in IPR/UR and licensing review functions;… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse Coordinator (40 Hour)...care facilities; + May lead an inspection team in IPR/UR and licensing review functions; ... Campus Hospital (https://portal.ct.gov/dcf/solnit-center/south) - is accepting applications for a Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=) (REGULATORY) position,… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team .This is a full-time role and will be required to work ... this position: *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include… more
- The County of Los Angeles (Los Angeles, CA)
- …information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team . Whether you're working in ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...so may result in an incomplete application and may lead to disqualification. We will send notifications to the… more
- Integra Partners (Troy, MI)
- …+ Provide day-to-day clinical leadership and oversight to the Utilization Review Medical Director(s) and clinical UM team . + Ensure consistent, accurate, ... operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director(s), ensures consistent application of criteria,… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... we understand that our greatest asset is our dedicated team of professionals. That's why we offer more than...level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as… more
- CVS Health (Columbus, OH)
- …We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team **Position Summary** The Team Lead plays a key role in supporting ... understanding of workflows, policies, and procedures to help ensure team success. The Team Lead ...including extended periods of sitting, computer use, and document review . + Participate in occasional on-call rotations, including some… more
- Devereux Advanced Behavioral Health (Viera, FL)
- **Description** Are you looking to advance your career in Admissions & Utilization Review ? If you answered yes, then consider joining our team where you can ... take your career to the next level. **Being the Utilization Review Coordinator at Devereux has its...others first, feel called to serve and called to lead . As a member of our team ,… 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: LVN/LPT $35.00-44.19 Per Hour ... RN/LCSW/LMFT/LPCC $54.00-68.18 Per Hour REPORTS TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as member of multi-disciplinary treatment … more
- UNC Health Care (Kinston, NC)
- …to support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying ... denial process. Reviews all denial requests and leads the team in the strategy to appeal all clinical denials....experience as a Registered Nurse required. + 2 years utilization review , care management, or compliance experience… more
- LifeCenter Northwest (Bellevue, WA)
- …General Responsibilities + Lead and engage daily with the Organ Utilization Coordinator (OUC) team in donor case operations, developing and implementing ... actions. + Contribute to LifeCenter Northwest's strategic planning efforts and the Organ Utilization Team 's operational plan. + Based on quality reviews of… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member… more
- LifeCenter Northwest (Bellevue, WA)
- …JOB FUNCTIONS Leadership Responsibilities + Oversees daily operations of the organ utilization team , including allocation processes for both transplantation and ... policies and regulatory standards. + Provides leadership for the organ utilization team , ensuring performance standards align with LifeCenter Northwest's… more
- CommonSpirit Health (Phoenix, AZ)
- …+ Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. + Physician Advisor Sub-specialty ... operational efficiency. As a member of the senior leadership team , the System Vice President of Utilization ...Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. **Required… more
- Alameda Health System (Oakland, CA)
- …by each individual in the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and performance ... utilization reviews and determine program improvements. + Develop and implement utilization review policies and procedures in accordance with industry… more
- UNC Health Care (Morrisville, NC)
- …People** - Operational oversight of centralized and site-specific UM teams, including utilization review nurses and support staff. Cultivate and empower ... of high-quality, value-based care across the healthcare system. **Responsibilities** : 1. ** Utilization Management** - Develop and lead a system-wide … more
- Wellpath (Lemoyne, PA)
- …role** The Medical Director of Utilization Management leads and oversees utilization review , case management, quality improvement, and related policy and ... there is one unifying characteristic of everyone on our team , it is the deep desire to make a...efforts to ensure quality patient care and the appropriate utilization of medical services. The Medical Director of … more
