- Hackensack Meridian Health (Hackensack, NJ)
- The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... population and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry ... this position is able to cover a multitude of utilization review functions through point of entry,...process improvements). **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates with the physician and all members of the interprofessional health care… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …+ Ongoing mentorship, _development,_ and leadership programs + And more **Description** The ** Utilization Review (UR) Specialist ** is a Registered Nurse ... with determining appropriate patient class designation. + The UR Specialist will perform timely and comprehensive reviews of the...experience or a minimum of two years of previous utilization review experience. + Licensure - Must… more
- Nuvance Health (Danbury, CT)
- …any issues/denials to department leadership.* 12) Forwards reviews that require secondary physician review to appropriate resource ( Physician Advisor) 13) ... one weekend per month Summary: The purpose of the Utilization Management Nurse is to support the physician...required. Education: ASSOCIATE'S LVL DGRE Required: 3 Years of Utilization Review experience(or a certification ACMA, MCG,… more
- HonorHealth (AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Hunterdon Health Care System (Flemington, NJ)
- Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure the effective and efficient ... an applicable health insurance plan. Primary Position Responsibilities 1. Performs utilization activities, using Milliman Care Guidelines under the guidance of the… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.Thisis a full-time role. *Purpose of this position: ... *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which...actions to UR Committees, as appropriate * Partners with Physician Advisor to engage in second level review… more
- UC Health (Cincinnati, OH)
- UC Health is hiring a Part-Time Lead Access Coordinator within the Utilization Review department for the First Shift that is Remote within the Greater Cincinnati ... The Lead Access Coordinator supports verification of insurance coverage utilization different on-line modalities for clinic patients receiving diagnostic testing… more
- HCA Healthcare (Henderson, NV)
- …growth, we encourage you to apply for our Consulting Provider Solutions Specialist opening. We promptly review all applications. Highly qualified candidates ... for benefits may vary by location._** We are seeking a(an) Consulting Provider Solutions Specialist for our team to ensure that we continue to provide all patients… more
- HCA Healthcare (San Antonio, TX)
- …and personal growth, we encourage you to apply for our Provider Solution Specialist opening. We promptly review all applications. Highly qualified candidates ... and integrity. We care like family! Jump-start your career as a Provider Solution Specialist today with IT&S - San Antonio Division. **Benefits** IT&S - San Antonio… more