- Mount Sinai Health System (New York, NY)
- …Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...EOW** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring… more
- Beth Israel Lahey Health (Plymouth, MA)
- …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding ... the multidisciplinary team to assess and improve the denial management , documentation, and appeals process. + Collaborates with UR...+ Current MA RN licensure + Bachelor's Degree in Nursing or advanced degree in healthcare preferred. + Three… more
- Beth Israel Lahey Health (Plymouth, MA)
- …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding ... the multidisciplinary team to assess and improve the denial management , documentation, and appeals process. + Collaborates with UR...+ Current MA RN licensure + Bachelor's Degree in Nursing or advanced degree in healthcare preferred. + Three… more
- Henry Ford Health System (Warren, MI)
- …+ Bachelor of Science Nursing required OR four (4) years Case Management / Appeal/ Utilization Management experience in lieu of bachelor's degree. ... Under minimal supervision, reviews and screens the appropriateness of services, the utilization of hospital resources and the quality of patient care rendered.… more
- Saint Luke's (Kansas City, MO)
- …assuring the receipt of high quality, cost efficient medical outcomes through utilization review and management . This position includes monitoring patient charts ... using clinical guidelines (InterQual). + Complies with CMS regulation regarding utilization review/ management . + Obtains and manages insurance authorizations and… more
- WMCHealth (Valhalla, NY)
- … Coordinator Company: Westchester Medical Center City/State: Valhalla, NY Category: Nursing / Nursing Management Department: Clinical Care Management ... the implementation or investigation of the procedures specified in the Quality Management , Utilization Review and Discharge Planning Program at Westchester… more
- WMCHealth (Valhalla, NY)
- … Coordinator Company: Westchester Medical Center City/State: Valhalla, NY Category: Nursing / Nursing Management Department: Clinical Care Management ... the implementation or investigation of the procedures specified in the Quality Management , Utilization Review and Discharge Planning Program at Westchester… more
- Catholic Health Services (Melville, NY)
- …from payors for additional clinical documentation. + Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as ... has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a...current with industry standards and business objectives related to Utilization and Care Management as appropriate. +… more
- Prime Healthcare (Reno, NV)
- …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... 5. Excellent interpersonal skills to build effective partnering relationships with physicians, nurse staff, coding staff and hospital management staff. 6.… more
- HonorHealth (AZ)
- …hospitals, health plans and vendors, as required. Works closely with the Medical Director, Utilization Management , Nursing , the Chief Medical Officer and the ... Oversees clinical operations for managed care plan contracts including utilization management , case management , and...staff and members of all related system departments, especially Nursing . Plays a leadership role with Case Management… more