- Community Health Systems (Franklin, TN)
- …discharge planning, and payer requirements. + Documents all utilization review activities in the hospital's case management software, including clinical ... Bachelor's Degree in Nursing preferred + 2-4 years of clinical experience in utilization review , case management , or acute care nursing required + 1-3 years… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …in relation to skill set *_QUALIFICATIONS:_* /*Minimum Qualifications:*/ * 1 year of recent* utilization review , utilization management or care ... ICU, ED, or case management ) * Strong understanding of utilization review / utilization management principles * Familiarity with InterQual, MCG,… more
- Catholic Health Services (Melville, NY)
- …ensure timely follow through. + Reviews providers' requests for services and coordinates utilization /appeals management review . + Assist Utilization and ... Utilization and Appeals Coordinator will perform activities to help facilitate utilization management and appeals functions to include coordination of… more
- CaroMont Health (Gastonia, NC)
- …license to practice in NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management , Quality and/or Case Management ... to MCO via fax, Provider Link, or telephonically. Gathers and disseminates Utilization Management information to medical staff departments, Nursing departments,… more
- Spectrum Billing Solutions (Skokie, IL)
- …+ Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist ... Utilization Review Specialist | ABA Utilization Review Specialist | ABA Utilization Management Specialist | ABA UR Specialist | Behavioral Health… more
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr-CMC-Clear Lake Center; M-F, 3:00 PM - 11:00 PM **Webster, Texas, United States** **New** Nursing & Care Management UTMB Health ... efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions,… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** ... + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
- YesCare Corp (Brentwood, TN)
- …as indicated. + Communicate and guide staff and physicians regarding utilization management program development, implementation, and evaluation and ... practice. + Facilitate quality health care intervention recommendations. + Review and assess over/under utilization issues. +...license + No less than 5 years' experience in utilization management , case management , quality… more
- Centene Corporation (San Diego, CA)
- …abuse addiction disorders experience is required. + Direct experience with Utilization Review or Utilization Management related to Behavioral Health case ... or Remote - TX** **Position Purpose:** Performs a clinical review and assesses care related to mental health and...experience is preferred + Experience in Behavioral Health Case Management or Utilization Management in… more
- BriteLife Recovery (Englewood, NJ)
- …assigned What we need from you? + Minimum of 2-3 years of experience in utilization review , case management , or insurance coordination in a behavioral health ... What you will be doing? The Utilization Review (UR) Specialist is a...Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in… more