- University of Maryland, Baltimore (Baltimore, MD)
- …with Board Certification. They must be licensed or eligible to be licensed as a physician in the State of Maryland. *_Position Highlights_* * Level III NICU: 20 bed ... to the delivery of medical care and clinical services such utilization review, quality assurance, policies, procedures and guidelines development. 3. Participates… more
- John Muir Health (Walnut Creek, CA)
- **Job Description:** As a member of the John Muir Health Physician Practices (JMHPP) Practice Development and Innovation team, the Coordinator, Patient Access ... improvement analysis, implements solutions where necessary and assures appropriate utilization . The Coordinator PAO actively collaborates with physicians, practice… more
- Catholic Health Services (Roslyn, NY)
- …compliance with regulatory and external review agencies. + Participates in the Utilization Management Committee, reporting data on utilization trends, resource ... and denials. + Serves as a resource to physicians, physician advisors, CM department, and hospital staff. + Collaborates...resolution of issues. + Refers cases and issues to Physician Advisor in compliance with identified procedures and follow-up… more
- Northwell Health (Melville, NY)
- …and knowledge gaps. Job Responsibility + Serves as liaison between the patient and facility/ physician and the third party payer. + Prepares and defends level of care ... and medical necessity for assigned case. + Collaborates with physician advisor, payor representative and site case managers to facilitate appropriate level of care… more
- Fallon Health (Worcester, MA)
- …Collaborates with attending physicians and health care professionals regarding appropriate utilization of medical services * Completes level of care/service request ... limited to, CMS, NCQA, and the DOI * Identifies utilization issues unique to their team assignment and identifies...benefit eligibility, and network contract status criteria to a physician reviewer for consideration, ensuring the timely review of… more
- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient ... of approvals from insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use of hospital… more
- Sharp HealthCare (San Diego, CA)
- …HMO insurance authorization for HMO patients through SRS Utilization Management.Obtains surgical PPO insurance authorizations.Obtains pre-authorization for all ... + Clinic OperationsAs a Key User, makes appropriate daily physician schedule changes.Schedules patients' clinical appointments following appropriate provider… more
- Nuvance Health (Poughkeepsie, NY)
- …documentation is complete and accurate and reflects severity of illness and resource utilization . Participates in the education of all members of patient care team ... etc.) to clarify potential documentation opportunities. Extensively reviews all physician and clinical documentation, lab results, diagnostic information, treatment… more
- Henry Ford Health System (Rochester, MI)
- …Team under the direct supervision of a Registered Nurse (RN) and/or a Physician and collaborates with all members of the Endoscopy Team. Adheres to accepted ... special endoscopes and procedures. + Anticipate and prepare for the needs of the physician and Endoscopy Team. + Assist with pre-procedure care of the patient. +… more
- Texas Health Resources (Dallas, TX)
- …our community. THPG includes more than 1,000 physicians, nurse practitioners and physician assistants dedicated to providing quality, patient-safe care at more than ... including the pilot, implementation, and monitoring of strategic initiatives, physician relationships, and staff development. This position reports directly to… more