- Carle Health (Champaign, IL)
- …Administrator (RHIA) - American Health Information Management Association (AHIMA); Licensed Registered Professional Nurse ( RN ) - Illinois Department of ... nurses, ancillary staff, and the coders in Health Information Management to identify and record principal and secondary diagnoses,...peers and providers we needed or requested. Reviews DRG denials and provides information to the denials … more
- AnMed Health (Anderson, SC)
- …position is responsible for performing the daily operations of the Utilization Management program at AnMed within the Care Coordination model. These duties include ... necessity review, continued stay/concurrent review, retrospective review, bed status management , resource utilization management , regulatory compliance, and… more
- Henry Ford Health System (Troy, MI)
- …involving all appropriate personnel. Prepares reports and recommendations for management and coordinates implementation. The Revenue Integrity Specialist ... SUMMARY: Reporting to the Manager, Revenue Integrity, the Revenue Integrity Specialist identifies revenue opportunities and works collaboratively with Revenue Cycle… more
- UnityPoint Health (Cedar Rapids, IA)
- …S + Shift: 0900-1700 + Job ID: 174223 Overview The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves ... clinical outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management function for...to quality care, effective utilization of resources and pursues denials of payment and referrals in a timely, legible… more
- BriteLife Recovery (Englewood, NJ)
- …+ Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials , approvals, and ... What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team...of 2-3 years of experience in utilization review, case management , or insurance coordination in a behavioral health or… more
- CaroMont Health (Gastonia, NC)
- …physicians regarding utilization issues. Collaborates with discharge planning specialist and other disciplines. Retrospectively reviews discharged medical record ... via fax, Provider Link, or telephonically. Gathers and disseminates Utilization Management information to medical staff departments, Nursing departments, Care … more
- Trinity Health (Livonia, MI)
- …or Nursing or equivalent in experience. Must possess one of the below: + Current Registered Nurse ( RN ) License + Registered Health Information ... Specialist and Clinical Documentation Integrity Coordinator positions, facilitating management of personal time off and schedule change requests, assuring… more
- Rochester Regional Health (Rochester, NY)
- …experience preferred. + Experience with EPIC preferred. EDUCATION: BS LICENSES / CERTIFICATIONS: RN - Registered Nurse - New York State Education ... and performance standards. + Provides direct managerial oversight to CDI Team in management of CDI processes CDI projects, barriers and education work processes, to… more
- AdventHealth (Tampa, FL)
- …you'll need to succeed:** Associate's of Nursing Required. 1 years Related Experience Required Registered Nurse ( RN ) current FL Required CCDS - Certified ... **ue you'll bring to the team:** Ensures competency of Clinical Documentation Specialist staff by conducting on-going reviews and skills assessments; provides action… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …in confidentiality, integrity, creativity, and initiative */License/Certifications:/* * Current Registered Nurse licensure upon hire * National certification ... functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, financial, and… more