- Covenant Health Inc. (Morristown, TN)
- …to ensure processes are in place to achieve desired outcomes. + Collaborates with the Peer Review /PQPR medical staff chair to operationalize assessments ... of peer review triggers and functions of the facility medical staff . + Collaborates with clinical and medical staff to implement processes, as… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... development specialist to develop standard work and expectations for the utilization review process, including timely medical necessity screening to ensure… more
- Veterans Affairs, Veterans Health Administration (St. Louis, MO)
- …coding, billing, and workload capture. Participate in Surgical Service meetings, peer review , and quality improvement initiatives. Serve as Collaborating ... Surgical Service Executive Committee Wound Care Board Operating Room Committee Medical Staff Bylaws Committee Credentialing and Privileging Committee Research… more
- Veterans Affairs, Veterans Health Administration (Detroit, MI)
- …as initiatives designed to improve overall quality through evidence-based medicine and peer review . Participates and facilitates implementation of modern care, ... notification of time-sensitive results and/or results that have major clinical significance. Medical Staff Functions: Participate in Imaging and general … more
- Veterans Affairs, Veterans Health Administration (Syracuse, NY)
- …or President of the Medical Staff . There may be non-committee peer review or quality assurance duties that are required on an occasional basis. ... Center Bylaws. 10. Psychiatrists are expected to serve on peer review and other committees as requested...review and other committees as requested by the Medical Center Director, Chief of Staff , BVAC… more
- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- …relate to performance measures. Functions independently as a member of the Medical Staff , with full clinical privileges. Assumes complete professional ... individual, family and group psychotherapy. Provides consultation to professional staff within the medical center and to...Director and Chief of Mental Health Service. Complies with peer review /case presentation procedures and attends … 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 ... activities. This role collaborates with payers, hospital staff , and clinical specialists to secure timely authorizations for hospital admissions and extended stays.… more
- Community Health Systems (Franklin, TN)
- …mitigate concurrent denials by submitting reconsiderations or coordinating peer -to- peer reviews. + Communicates effectively with utilization review ... to enhance utilization management. + Serves as a key contact for facility staff and insurance representatives regarding utilization review concerns. + Supports… more
- AdventHealth (Altamonte Springs, FL)
- …agreements + Affiliation agreements + Due diligence + HIPAA + Peer review + Medical staff issues + Licensing + Informed consent + Various types of ... issues. This individual will advise CEOs, executive management, compliance department, and medical staff leadership on a wide variety of health care and legal… more
- Veterans Affairs, Veterans Health Administration (St. Louis, MO)
- …and Professional Duties Attend Surgical Service meetings and participate in peer review and quality improvement initiatives. Collaborate with nursing ... , APPs, and case managers to coordinate external referrals. Review and integrate external operative and imaging reports into...verified practice in the United States), which the local Medical Staff Executive Committee deems to have… more