- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Specialist + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Care Management + $61.76/hr - ... observation, outpatient). 3. Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may not meet medical necessity… more
- Hunterdon Health Care System (Flemington, NJ)
- Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure the effective and efficient use of hospital ... services and monitors the appropriateness of hospital admissions and extended hospital stays. The evaluation of the...Milliman Care Guidelines under the guidance of the Physician Advisor , to provide clinical information to payors as requested… more
- AT Still University (Mesa, AZ)
- …of heritage slides to campus monitors + Coordinate annual pre-health, and STEAM advisor mailings + Oversee updates and edits of all department literature and ... brochures + Become a specialist in the residential and Online ATSU programs and...residential and Online ATSU programs and remain current on admissions requirements and acceptance statistics for all ATSU programs… more
- Trinity Health (Darby, PA)
- …InterQual, Milliman Care Guidelines (MCG), and payor guidelines. Reduces unnecessary admissions to the acute care hospital. Has accountability for recommending ... Also collaborates with Social Work to ensure appropriate primary care and specialist physician follow up. Collaborates with the ED healthcare team to determine… more
- LifePoint Health (Hickory, NC)
- …in the lives of those we serve.** *Connect with our RN recruiting specialist * Not ready to complete an application, or have questions? Please contact Jennifer ... reviews. *7. Case Management** Acts as gatekeeper for hospital admissions by initiating care in the ED. * Encourages...and follows reporting procedures. * Refers cases to Physician Advisor or secondary reviewer and follows up as needed.… more
- UCLA Fielding School of Public Health (Los Angeles, CA)
- …Transfer program. C. CAMPUSWIDE CONTRIBUTION TO DIVERSITY Serving as the Divisions' Equity Advisor /Diversity Specialist and working with the Vice Chancellor for ... the division of Student Affairs and to the Office of Undergraduate Admissions and Relations with Schools and Outreach Steering Committee. Responsible for organizing… more