- CommonSpirit Health (Phoenix, AZ)
- **Job Summary and Responsibilities** The System Vice President of Utilization Management is a key member of the healthcare organization's leadership team and is ... organization's goals and objectives for assuring the effective, efficient utilization of health care services. This role will be...required. + Minimum 7 years of experience in a director level, or equivalent leadership role, required. + Prior… more
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr - CMC - Clear Lake Center - Compressed weekend night shift Friday - Sunday **Webster, Texas, United States** **New** Nursing & Care ... efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions, all… more
- University of Utah Health (Salt Lake City, UT)
- …advancement, and overall patient outcomes. **Responsibilities** + Applies approved utilization criteria to monitor appropriateness of admissions with associated ... for the inpatient stay. + Discusses with physicians the appropriateness of resource utilization . + Tracks length of stay (LOS) and resource utilization to… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and appeals ... timely authorizations for hospital admissions and extended stays. The Utilization Review Coordinator monitors and documents all authorization activities, assists… more
- University of Utah Health (Salt Lake City, UT)
- …trust that are integral to our mission. EO/AA_ + The Staff Utilization Coordinator is responsible for providing healthcare operational support services, including ... Timekeeping team. + Collaborating closely with Nursing Leadership, the Staff Utilization Coordinator reviews and develops schedules based on agreed-upon staffing… more
- George C. Grape Community Hospital (Hamburg, IA)
- Quality/ Utilization Review Nurse Position Summary: The Quality/ Utilization Review Nurse is responsible for evaluating the medical necessity, appropriateness, and ... to infection prevention protocols and regulatory compliance. Key Responsibilities: * Utilization Review: o Conduct concurrent and retrospective reviews of patient… more
- Saint Francis Health System (OK)
- …in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers the details of ... issues and participate in treatment teams, Patient Care Committee, and the Utilization Review Staff Committee by providing data and contributing to the improvement… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review ... coverage while working remotely. Primary Responsibilities * Performs clinical utilization reviews using evidenced based guidelines, policies and nationally… more
- Children's Mercy Kansas City (Kansas City, MO)
- …hospital. Overview To provide leadership to integrated inpatient teams; assists Director in the management of department; including personnel and fiscal management ... and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient statusing… more
- Albany Medical Center (Albany, NY)
- …States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. * ... Completes Utilization Management and Quality Screening for assigned patients.* Applies...in both areas.* Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures… more