- HonorHealth (AZ)
- …it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors utilization of health care services ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Guthrie (Binghamton, NY)
- …services regarding admissions, case management, discharge planning and utilization review . Responsibilites: Reviews admissions and service requests within assigned ... with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversees and coordinates compliance to federally mandated… more
- Sanford Health (Fargo, ND)
- …medical images, review preliminary reports and images with a supervising physician , and prepare technical reports that will be reviewed and signed off by ... including prescriptive powers for acquisition of additional imaging procedures, following review with the supervising physician . Maintain values congruent with… more
- Mount Sinai Health System (New York, NY)
- …interdisciplinary approach to acute/primary health care delivery. i. Performs a patient record review with the collaborating physician in a timely fashion but ... in the specific clinical area and performs a periodic review of the collaborative agreement. b. Assesses the health...care in the patient's medical record. f. Consults with physician as established in the collaborative practice agreement. g.… more
- Molina Healthcare (San Francisco, CA)
- …+ Provides telephone, clerical, and data entry support for the Care Review team. + Provides computer entries of authorization request/provider inquiries, such as ... phone, fax, and mail according to Molina operational timeframes. + Contacts physician offices according to Department guidelines to request missing information from… more
- Beth Israel Lahey Health (Plymouth, MA)
- …using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal clinical denials related to the care provided to ... management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding cases that do not meet established guidelines for… more
- Dignity Health (Santa Maria, CA)
- …and other physical therapy assessment techniques. Accurately interprets the physician 's order. Measurement: Discussion, Feedback, Chart Review , Observation. ... abuse and neglect of elders and children. Measurement: Feedback, Chart Review , Observation. + Annual Performance Evaluations: Assists Therapy Manager/Supervisor in… more
- Atlantic Health System (Morristown, NJ)
- …and to ensure safe, effective and efficient patient care. Develops, with our physician colleagues, a system-wide quality review program. Ensures compliance with ... Under the supervision of the Assistant General Counsel (ACG), review prepare and negotiate a full range of hospital contracts including, without limitation, … more
- BrightSpring Health Services (Arroyo Grande, CA)
- … of body systems on assigned individuals per program requirements. Refer to physician any assessment findings needing further review . + Ensures incidents are ... observation of client's health status, assists the RN and physician in treatments and communicating with clients and their...direction of the RN and as ordered by the physician , provides direct care as outlined in the Service… more
- BrightSpring Health Services (Marietta, OH)
- … of body systems on assigned individuals per program requirements. Refer to physician any assessment findings needing further review .* Ensures incidents are ... observation of client's health status, assists the RN and physician in treatments and communicating with clients and their...direction of the RN and as ordered by the physician , provides direct care as outlined in the Service… more