- Sharp HealthCare (San Diego, CA)
- …roundsReviews every patient under assigned workload initially and reviews based on review of care plan.Makes rounds and sees every patient identified per ... departmental guidelines during hospital stay beginning with the admission review of the case manager and reviews with the Case Manager Lead, as needed.Keeps SRS… more
- Prime Healthcare (Sherman Oaks, CA)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/239073/case-manager- utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... Team of Dedicated Healthcare Workers Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the… more
- Prime Healthcare (Ontario, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236094/ utilization - review -nurse-lvn/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... (2) two years of experience in acute hospital case management or equivalent. + Utilization Management...acute hospital case management or equivalent. + Utilization Management experience required. + Excellent interpersonal… more
- Liberty Healthcare Corporation (Salisbury, MD)
- …people who are living with developmental disabilities + Service coordination + Case management + Utilization review + Prior authorizations + Claims ... their best lives. To support this initiative, Liberty is now hiring for a full-time Utilization Reviewer position. As a Utilization Reviewer , your daily… more
- Helio Health Inc. (Syracuse, NY)
- …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more
- Georgetown Behavioral Health Institute (Georgetown, TX)
- …Knowledgeable of insurance coverage and billing practices preferred. Previous experience in utilization review or case management desirable. + Knowledge, ... a 118 bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator. This position is responsible for working with… more
- UNC Health Care (Kinston, NC)
- …years of applied clinical experience as a Registered Nurse required. + 2 years utilization review , care management , or compliance experience preferred. + ... support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying established… more
- Prime Healthcare (Philadelphia, PA)
- … utilization review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone ... Organizations, the nation's oldest and largest hospital accreditation agency. Responsibilities The Utilization review tech essentially works to coordinate the… more
- Houston Methodist (Houston, TX)
- … of resources. This position is a key member and leader of the hospital's utilization review / management committee, which is charged with regulatory goals of ... care, length of stay, and quality issues. + Chair the utilization review / management committee, actively participates in defining operational strategic… more
- Tenet Healthcare (Detroit, MI)
- … Utilization Management Plan using data to drive hospital utilization performance improvement, c) ensures medical necessity review processes are completed ... case management scope of services including: * Utilization Management supporting medical necessity and denial...interpretation of department policies, in accordance with the DMC Utilization Review Plan. Identifies the need for… more