- YesCare Corp (Brentwood, TN)
- …As a pioneer in correctional healthcare services, YesCare is committed to innovation, clinical expertise, and compassionate care . By choosing a career with ... quality health care intervention recommendations. + Review and assess over/under utilization issues. + Track, trend and evaluate appropriateness and quality of … more
- WestCare Foundation (Henderson, NV)
- Utilization Review Specialist Job Details Job Location Henderson - 1711 Whitney Mesa - Henderson, NV Position Type Full Time Education Level 2 Year Degree Salary ... Summary: Person in this position is responsible for collecting clinical information and communicating with MCOs in a timely...in order to advocate for the highest level of care that is supported by the clients acuity, and… more
- Medical Center Hospital (Odessa, TX)
- + Position Summary: The Utilization Review Specialist /Outcomes Specialist conducts concurrent and retrospective review functions in support of the hospital ... Utilization Review Program and makes appropriate referrals to designated...Licensed Vocational Nurse. B. Training and Experience: Three years clinical nursing experience in general medical/surgical setting or appropriate… more
- Hackensack Meridian Health (Hackensack, NJ)
- …include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care , as outlined in ... **The Senior Utilization Review Specialist collaborates with the...and resolution of activities that assure the integrity of clinical records for the patient population and Hackensack UMC.… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay.… more
- Sanford Health (Sioux Falls, SD)
- …monitoring the utilization of resources, risk management and quality of care for patients in accordance with guidelines and criteria. Assist in report ... 40.00 **Salary Range:** $27.50 - $38.50 **Job Summary** Conduct level of care medical necessity reviews within patient's medical records. Performs utilization … more
- TEKsystems (Canoga Park, CA)
- …ensure medical necessity, compliance, and timely processing within a managed care environment. Key Responsibilities + Perform comprehensive utilization reviews ... medical records for review by medical directors and provide clinical recommendations. + Ensure compliance with managed care...or LVN license. + 3-5 years of experience in utilization management or managed care authorization. +… more
- TEKsystems (Canoga Park, CA)
- …necessity and compliance, ensuring timely and accurate processing in a managed care environment. Key Responsibilities: + Perform detailed utilization reviews for ... records for medical directors and provide recommendations based on clinical review. + Ensure compliance with managed care...have 3-5 years of experience. + Experience in managed care authorization and utilization management. + Strong… more
- SSM Health (St. Louis, MO)
- …Hospital 1201 Grand **Worker Type:** Regular **Job Summary:** Optimizes patient care by promoting rational, safe, and cost-effective drug therapy by developing ... and providing clinical services in their area of expertise. Conducts drug...**Job Responsibilities and Requirements:** PRIMARY RESPONSIBILITIES + Provides pharmaceutical care in their specialty practice area which may include:… more
- Penn Medicine (Lancaster, PA)
- …no weekends or holidays. Penn Medicine Lancaster General Health is seeking a Clinical Nurse Specialist (CNS) **_or_** CNS Fellow with Cardiac and/or Critical ... the continuum of care to promote team building and to provide clinical consultation and education. + Collaborates with nursing personnel and other health care… more