- Community Health Systems (Franklin, TN)
- …discharge planning, and payer requirements. + Documents all utilization review activities in the hospital's case management software, including clinical ... Nursing preferred + 2-4 years of clinical experience in utilization review , case management , or...Compact State Licensure required + CCM - Certified Case Manager preferred or + Accredited Case Manager … more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Helio Health Inc. (Syracuse, NY)
- …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more
- Ochsner Health (Jefferson, LA)
- …This job manages expense management , vendor relationships, contract management , standardization and consolidation processes and utilization analysis. ... supply utilization improvements. + Good judgment, organizational and time management skills. + Consulting and group presentation skills. + Ability to travel… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and ... secure timely authorizations for hospital admissions and extended stays. The Utilization Review Coordinator monitors and documents all authorization activities,… more
- Ryder System (Nashville, TN)
- …Fleet Maintenance and Supply Chain Services in the World! **Summary** The **Asset Utilization Manager ** is responsible for optimizing the total life cycle value ... _Job Seekers can review the Job Applicant Privacy Policy by clicking...of vehicle assets to improve utilization and financial return on all assets. Working with… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** ... + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
- Dignity Health (Gilbert, AZ)
- …the Director of Care Management , performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... Accredited Case Manager (ACM-RN), or UM Certification + Utilization Review experience **Where You'll Work** Hello humankindness… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for… more
- BayCare Health System (St. Petersburg, FL)
- …trust, dignity, respect, responsibility and clinical excellence. **The Team Lead Utilization Review responsibilities include:** + Directing and coordinating the ... of Case Management or 3 years of Utilization Management or 6 years of clinical...Community discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Team Lead **Location** St Petersburg:St… more