- Prime Healthcare (Passaic, NJ)
- …follow up on all denials while working closely with the Corporate/Facility Utilization review teams, Business Office and Case Managers. The Utilization review ... Truven Health Analytics. For information, visitwww.smh-nj.com. Responsibilities The Utilization review tech essentially works to coordinate the utilization review… more
- Centene Corporation (New York, NY)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all ... requiring authorization. Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care… more
- Albany Medical Center (Albany, NY)
- …Department.* Demonstrates proper use of MCG and documentation requirements through case review and inter-rater reliability studies.* Facilitates removal of ... documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and contacts… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …_development,_ and leadership programs + And more **Description** The **Utilization Review (UR) Specialist** is a Registered Nurse responsible for conducting ... and external customers. + Assists in collaborative efforts with the Case Management Department, Revenue Cycle, Physician Advisors, and other required departments.… more
- BriteLife Recovery (Englewood, NJ)
- …What we need from you? + Minimum of 2-3 years of experience in utilization review , case management, or insurance coordination in a behavioral health or substance ... What you will be doing? The Utilization Review (UR) Specialist is a critical member of...EHR and UR logs. + Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and… more
- Actalent (Porterville, CA)
- …+ Understanding of utilization management processes. Additional Skills & Qualifications + Case management experience. + Clinical review skills. + For Health ... Remote Concurrent Review Nurse Job Description We are seeking a dedicated Concurrent Review Nurse to perform concurrent reviews, assess members' overall health,… more
- CalSTRS (Sacramento, CA)
- Job Posting: Payment Review Manager State Teachers' Retirement System JC-490733 - Payment Review Manager PENSION PROGRAM MANAGER I $7,216.00 - $8,971.00 per ... as an Pension Program Manager I in the Payment Review Unit. The Disability and Survivor Benefits (DaSB) Division...l assists in the division's strategic planning related to case management, production goals, training needs, legislative reviews and… more
- State of Georgia (Fulton County, GA)
- Clinical Evaluator- Sexual Offender Risk Review Board- Atlanta Georgia - Fulton - Atlanta ... Job Alerts Job Description Job Title: Clinical Evaluator- Sexual Offender Risk Review Board- Atlanta Pay Grade: K Job Summary: Title Clinical Evaluator Department(s)… more
- Prime Healthcare (Ontario, CA)
- …follow up on all denials while working closely with the Corporate/Facility Utilization review teams, Business Office and Case Managers. The Utilization review ... members to join our corporate team! Responsibilities The Utilization review tech essentially works to coordinate the utilization ...review tech essentially works to coordinate the utilization review and appeals process as part of the denial… more
- Ascension Health (Baltimore, MD)
- …the offer._ **Responsibilities** Provide health care services regarding admissions, case management, discharge planning and utilization review . Responsibilities: ... medical necessity and/or compliance with reimbursement policy criteria. Provide case management and/or consultation for complex cases. + Assist departmental… more