- Behavioral Center of Michigan (Warren, MI)
- …all state mandated regulations. Maintains compliancy with regulation changes affecting utilization management . Reviews patient recrods and evaluates patient ... tasks requested by the UR Manager, CEO or Medical Director to meet the needs of the Center. Perform...and advises physicians and other departments of regulations affecting utilization management . Consults with Social Services Department… more
- Integra Partners (Troy, MI)
- … Director ) with administrative and non-clinical tasks related to processing Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES + ... external sources + Other duties as assigned by UM Director + Strong organizational skills, ability to adapt quickly...expectations and functions of the UM team + Time Management What will you achieve in the first 12… more
- Community Health Systems (Franklin, TN)
- …preferred **Knowledge, Skills and Abilities** + Strong knowledge of utilization management principles, payer requirements, and healthcare regulations. ... Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials...part of the application or hiring process, contact the director of Human Resources at the facility to which… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of our hospital. Overview To provide leadership to integrated inpatient teams; assists Director in the management of department; including personnel and fiscal ... of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient… more
- US Tech Solutions (Columbia, SC)
- …established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to ... determinations. Identifies and makes referrals to appropriate staff (Medical Director , Case Manager, Preventive Services, Subrogation, Quality of Care Referrals,… more
- George C. Grape Community Hospital (Hamburg, IA)
- …* Education & Collaboration: o Educate clinical staff on documentation requirements, utilization management processes, and infection control standards. o Serve ... of clinical nursing experience (acute care preferred). o Prior experience in utilization review, case management , quality improvement, and infection control… more
- Albany Medical Center (Albany, NY)
- …Day (United 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 MCG...in both areas.* Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures… more
- Prime Healthcare (Pampa, TX)
- …Us! (https://careers-primehealthcare.icims.com/jobs/241073/coordinator pi prmc- utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... information visit www.prmctx.com . Responsibilities In collaboration with the manager/ director of Performance Improvement, the coordinator is responsible for… more
- Sharp HealthCare (San Diego, CA)
- …or services, readmissions to acute or visit to the Emergency Department.Informs Director , QI/UM of any quality issues.Attends hospitalists rounds, as required, to ... discuss high risk patients requiring case management follow up.Attends clinical in-services or required operational/clinical training sessions. + Act as a… more
- Houston Methodist (Katy, TX)
- …oversight for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is responsible for ... At Houston Methodist, the Sr Director Case Management position is responsible...needed. + Collaborates with HMCPA on care transition and utilization management initiatives. + Provides strategic vision… more