- MTC (Chaparral, NM)
- …the use of appropriate sanitation methods. 6. Practice basic cost containment and utilization management for patient care and facility operations. 7. Maintain ... **Make a difference in health care! Operated by the Management & Training Corporation, Otero County Processing Medical Center...of all medical records; observe applicable HIPAA rules. 8. Review medical files to determine all provided services are… more
- MTC (Raymondville, TX)
- …the use of appropriate sanitation methods. + Practice basic cost containment and utilization management for detainee care and facility operations. + Maintain ... of all medical records. Observe applicable HIPAA rules. + Review medical files to determine all provided services are...with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is… more
- MTC (Graceville, FL)
- …record or other forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. + Maintain absolute ... HIPAA rules. + Accurately and promptly chart medical care. Review medical files to determine all provided services are...with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is… more
- Fresenius Medical Center (Atlanta, GA)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- CVS Health (Hartford, CT)
- …**Preferred Qualifications** * Appeals Experience * Managed Care Experience * Utilization review experience * Proficiency with computer skills including ... with heart, each and every day. **Position Summary** Responsible for the review and resolution of clinical appeals. Reviews documentation and interprets data… more
- Nuvance Health (Carmel, NY)
- …in an acute care setting; Leadership experience preferred; Utilization review , discharge planning or case management experience preferred. Location: ... Carmel-PHC 670 Stoneleigh Avenue Work Type: Full-Time Standard Hours: 37.50 FTE: 1.000000 Work Schedule: Day 10 Work Shift: This is a Monday thru Friday position with rotating weekends. 8am-4pm Org Unit: 1168 Department: Care Coordination Exempt: Yes Grade:… more
- Molina Healthcare (NM)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN (preferred) or LPN with a compact license who resides in New Mexico or Texas. This team ... 3-5 years clinical practice with managed care, hospital nursing or utilization management experience. **Preferred License, Certification, Association** Active,… more
- Molina Healthcare (CA)
- …care unit (ICU) or emergency room. Previous experience in Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At… more
- Molina Healthcare (North Las Vegas, NV)
- …(ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At… more
- Pacific Medical Centers (Renton, WA)
- …functions needed to support a smooth, efficient referral process; assists the utilization review and case management nurse with management of ... referrals and monitoring or institutional patients. Providence caregivers are not simply valued - they're invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers in our culture of patient-focused, whole-person care built on understanding,… more
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