- 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
- Catholic Health Initiatives (Omaha, NE)
- …patients. **This position offers the flexibility to work remotely with proven Utilization Review experience.** Medical Coding experience is a plus! As our ... of a Commonspirit Health Facility Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and… more
- Houston Methodist (Houston, TX)
- …the prescribed time frame. Sets priorities and functional standards, giving direction to staff as necessary to ensure the best possible delivery of service and high ... and/or any specific accreditation/regulatory required safety guidelines. Responsible for staff maintenance of credentials and competencies, per accrediting/ licensing… more
- HCA Healthcare (Brentwood, TN)
- …and reporting purposes. This individual will assist in training and support of medical coding staff through education forums, written coding resources, creation ... invests in you as a Pro Fee Coding Quality Review Educator? At Parallon, you come first. HCA Healthcare...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: LVN/LPT $31.50-37.50 Per Hour RN/LCSW/LMFT/LPCC ... $54.00-64.00 Per Hour REPORTS TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as member of multi-disciplinary treatment team reviewing patient care… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …physicians. + Conduct clinical appeal case reviews and may require peer -to- peer discussions with providers regarding UM case review determinations. + ... and medical criteria. + Assists with training medical director colleagues and nursing staff ,...clinical appeal case reviews and may require peer -to- peer discussions with providers regarding UM case review… more
- Veterans Affairs, Veterans Health Administration (Fayetteville, AR)
- …and procedures for Mental Health Services and VHSO, participates fully in peer review , assessing the quality of professional psychology standards provided ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities Total Rewards of... Staff , Mental Health Services, the Chief of Staff , and the Medical Center Director, attends… more
- BriteLife Recovery (Englewood, NJ)
- …EHR and UR logs. + Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and up-to-date clinical information for reviews. ... of care. The UR Specialist works closely with clinical staff , admissions, medical providers, and third-party payers...staff on documentation best practices related to utilization review . + Special projects as assigned What we need… more
- Veterans Affairs, Veterans Health Administration (Iowa City, IA)
- …development and implementation of competencies, providing opportunities for continuing education, peer review , career development and professional enrichment for ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. Learn more EDRP Authorized:...verified practice in the United States), which the local Medical Staff Executive Committee deems to have… more
- Spectrum Billing Solutions (Skokie, IL)
- …authorization for treatment services. + Manage authorization denials including referral for peer review . + Demonstrate the ability to make critical decisions ... include: + Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial… more