- Penn Medicine (Lancaster, PA)
- …Medicine Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this critical role, you'll advocate for ... we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions is responsible...Strong critical thinking skills and the ability to perform clinical chart review efficiently. Strong analytical, data… more
- AnMed Health (Anderson, SC)
- … clinical knowledge to independently review the medical record for clinical appropriateness and resource utilization including but not limited to : ... review , continued stay/concurrent review , retrospective review , bed status management, resource utilization management,...patient acuity and related clinical services, applies approved medical necessity criteria for screening… more
- WestCare Foundation (Henderson, NV)
- …LPN or RN and/or Bachelors or Masters level CADC/LADC with 2 years utilization review experience, preferred experience working with individuals with psychiatric ... Description Position Summary: Person in this position is responsible for collecting clinical information and communicating with MCOs in a timely manner in order… 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
- 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
- UnityPoint Health (Cedar Rapids, IA)
- …174223 Overview This position is on site at St. Luke's Hospital. The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments ... optimal clinical outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management function for patients admitted to BH… more
- St. Peters Health (Helena, MT)
- The Utilization Management RN reports directly to Utilization Review RN Coordinator. The UR RN supports the UR RN Coordinator and other UR team members in ... providing all identified utilization review functions for the organization to...admission status and confirm treatment goals, treatment plan, and clinical mileposts used to advance the treatment plan. 12.… more
- UNC Health Care (Kinston, NC)
- …on status of at-risk dollars and appeal win rates. 12. Assists in documentation review in the clinical documentation specialist role when needed. Working ... documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by...on assigned Hospital Units. 13. Works closely with the Clinical Documentation Specialist Lead to develop provider… more
- HCA Healthcare (Dallas, TX)
- …compelling, we encourage you to apply for our Clinical Pharmacist Specialist BMT opening. We promptly review all applications. Highly qualified candidates ... includes monitoring patient medication regimens and providing appropriate interventions. The Clinical Specialist shall also assist in mentoring pharmacy staff… more
- UPMC (Bridgeville, PA)
- UPMC Rx Partners is looking for a full time Pharmacy Clinical Review Specialist to join their dedicated team! This position provides prescription data entry ... to Rx Partners Skilled nursing and Hospice clients. The clinical review specialist at Rx...of benefits, complaints and grievance guidelines and prescription drug utilization management required + Thorough knowledge in MS Office… more