- 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
- 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** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
- Samaritan Daytop Village (Rhinebeck, NY)
- …and goal of sustaining high quality care/service delivery to persons served, the Utilization Manager works to assist CASAC Counselors and supervisory staff as ... needed with assuring compliance with external and internal utilization review /quality and appropriateness requirements. What qualifications do you need: +… more
- Northeast Alabama Regional Medical Center (Anniston, AL)
- …years of clinical experience required. Leadership experience preferred. CM or Utilization Review experience preferred. Extensive knowledge and understanding of ... stay reviews to assure hospitalizations meet payor requirements. Maintains records of review information and outcomes for billing purposes and for compliance with… 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 ... + Community discounts and more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Team Lead **Location** St Petersburg:St Anthonys |… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... + Preferred ACM (Case Management) + Preferred CCM (Case Manager ) **Education:** + Required Associates in Nursing or +...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
- Providence (Mission Hills, CA)
- **Description** Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records ... strong clinical background combined with well-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination. The … more
- LifeCenter Northwest (Bellevue, WA)
- …a culture of collaboration, accountability, and continuous improvement across the organ utilization function. + Mentors and develops the manager (s) and lead ... Salary Position Type Full Time Description and Qualifications The Director, Organ Utilization (Director), is responsible for overseeing the processes and teams that… more
- Access Dubuque (Dubuque, IA)
- …The Utilization Management Assistant answers first level calls in Utilization Review for HealthCheck360 participants. They will evaluate certification ... will also triage the call to determine if a Utilization Review Nurse is needed to complete...Cottingham & Butler/ SISCO Risk Management and Accreditation Program Manager UnityPoint Health Finley Hospital Utilization Management… more
- Amergis (Santa Rosa, CA)
- The RN Case Manager is responsible for coordinating continuum of care activities for assigned patients and ensuring optimum utilization of resources, service ... delivery, and compliance with medical regime. Minimum Requirements: + Current RN licensure in state practicing + At least one year of Case Management experience preferred + Current CPR if applicable + TB questionnaire, PPD or chest x-ray if applicable +… more