- Northwell Health (Lake Success, NY)
- …up discussions with physicians for clarification of ambiguous or conflicting documentation . Job Responsibility 1 .Facilitates clarification of clinical ... **Req Number** 154380 Job Description Facilitates and obtains appropriate clinical documentation for all clinical conditions or procedures to support the appropriate… more
- Trinity Health (Columbus, OH)
- …peer review process including case identification through internal reporting data , registries, or the incident reporting system based on defined indicator ... growing major metropolitan areas in the Midwest - ranked # 1 for population growth, # 1 for job... needs. + Maintains provider files with all peer review -related documentation and communications. + Partners with… more
- Beth Israel Lahey Health (Burlington, MA)
- …medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized ... medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized… more
- Northrop Grumman (Annapolis Junction, MD)
- …specifications, blueprints, engineering illustrations, and trade journals + Conduct quality review of materials + Research engineering data /technical manuals and ... to develop documentation + Proficient in the interpretation of engineering data , such as parts lists, application lists, schematics, and blueprint readings +… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …facilitates meetings with payers, as appropriate * May participate in the Utilization Review Committee to present medical necessity data and outcomes and ... in services that may prolong length of stay; analyzes data to monitor trends for opportunities to improve services....(5) years clinical experience * A minimum of one ( 1 ) year of utilization review experience */Preferred… more
- MyFlorida (Tallahassee, FL)
- …spreadsheet, database, word processing) in a networked environment. + Ability to review data using computer applications and/or spreadsheets. The Benefits of ... OPERATIONS REVIEW SPECIALIST - 42001433 (FOR INTERNAL AGENCY EMPLOYEES...an accredited college or university can substitute for one ( 1 ) year of the required experience. Professional or nonprofessional… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …Nursing Practice and Nursing Research*: * Applies evidence-based criteria for utilization review decisions. Supports data collection and reporting to enhance ... Practice Model in relation to skill set *_QUALIFICATIONS:_* /*Minimum Qualifications:*/ * 1 year of recent*utilization review , utilization management or care… more
- Hawaii Pacific Health (Lihue, HI)
- …to patients, physicians, and other outside facilities for treatment, payment, or review . HIS is the custodian and gatekeeper for privacy of the organization's ... medical records and also generates the coding procedures for data collection, research, and reimbursement. With the widespread computerization of health records and… more
- US Tech Solutions (Chicago, IL)
- …with clinical policy, regulatory and accreditation guidelines. + Responsible for the review and evaluation of clinical information and documentation . + Reviews ... exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref.… more
- US Tech Solutions (May, OK)
- …with clinical policy, regulatory and accreditation guidelines. . Responsible for the review and evaluation of clinical information and documentation . . Reviews ... make recommendations to meet QM objectives Responsibilities: . Reviews documentation and evaluates Potential Quality of Care issues based...knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF… more
Recent Jobs
-
Chemistry Laboratory Technician
- Kelly Services (Tacoma, WA)
-
Retail Personal Designer - Custom Framing Sales and Production
- Michaels (TX)
-
Manager HR Operations
- Dignity Health (San Andreas, CA)
-
AI Engineer
- BOOZ, ALLEN & HAMILTON, INC. (Washington, DC)