- Universal Health Services, Inc. (Sparks, NV)
- …to determine the appropriate patient status. Collaborates with physician, physician extender, nurse , case manager/ utilization review and HIM coder to ... and utilizes strong communication skills with physician, physician extender, case manager, utilization review , nurse or other healthcare professional,… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary * VARIANCES ... case manager social work staff. Responsible for the initial review , triage and assignment of patients to case managers...by anticipating patient needs in collaboration with physicians, staff RN 's, and other health care team members * INTERVENTIONS… more
- Spectraforce Technologies (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review /case management/clinical/or combination; 2 of the 4 ... United States and in the state of hire OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) Preferred Education:… more
- Universal Health Services, Inc. (Memphis, TN)
- …and advocates for patient length of stay and level of care. Oversees utilization review activities with other departments to ensure reimbursement for services ... or LPC preferred. Knowledge: Must possess knowledge of psychiatric care, utilization review , insurance reimbursement procedures, DSM-V, etc. Advanced computer… more
- Spectraforce Technologies (Columbia, SC)
- …Bachelor's degree- Nursing. Preferred Work Experience: 7 years-healthcare program management, utilization review , or clinical experience in defined specialty. ... outcomes. Day to Day: 50% Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit...the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse … more
- Spectraforce Technologies (Columbia, SC)
- …Bachelor's degree- Nursing. Preferred Work Experience: 7 years-healthcare program management, utilization review , or clinical experience in defined specialty. ... outcomes. Day to Day: 50% Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit...the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse … more
- Universal Health Services, Inc. (Orlando, FL)
- …departmental orientations: Week 1: M-F 8 AM - 5 PM Position Summary The Utilization Review Coordinator performs admission and concurrent review of patients. ... to five (5) years' experience in chart analysis and utilization review in the psychiatric and chemical...and chemical dependency filed preferred. Valid FL license, eg, RN , LSCW, LMHC or LMFT preferred. Good oral and… more
- Universal Health Services, Inc. (Rosemead, CA)
- …plans, interfacing with the treatment team/external case managers, authorizations, and utilization review with managed care organizations. This position also ... and the quality of care. Assure proper tracking and completion of all utilization reviews, working with third party payors regarding certified days. Contribute to… more
- Commonwealth Care Alliance (Boston, MA)
- …understanding of CCA's mission, value-based approach, and expectations for quality, utilization , and member experience. - Address provider inquiries related to care ... coordination, utilization management, and program participation, collaborating with internal teams...BH and Health Home providers. - Participate in case review meetings and rounds as needed to enhance coordination… more
- Medica (Minnetonka, MN)
- …Key Accountabilities Conducting regularly scheduled member outreach calls to address utilization gaps including post-discharge follow up, frequent ER use and ... nursing experience with focus in chronic condition management, post-acute, utilization management, or case management preferred Required Certifications/ Licensure… more
