- St. Peters Health (Helena, MT)
- The Utilization Management RN reports directly to Utilization Review RN Coordinator. The UR RN supports the UR RN Coordinator and other UR team members ... licensure in the State of Montana. Certification in Case Management and/or Utilization Review desired. APTITUDES: * Excellent interpersonal communication… more
- UnityPoint Health (Cedar Rapids, IA)
- …174223 Overview This position is on site at St. Luke's Hospital. The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments ... outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management function for patients admitted to BH HODs effective… more
- Integra Partners (Troy, MI)
- …funded programs; no OIG sanctions + 5+ years of utilization management experience, including complex case review + Prior leadership experience overseeing ... Director (Senior MD) serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This is a full-time, 40+… more
- Catholic Health (Kenmore, NY)
- …Weekend and Holiday Rotation Hours: 8 am- 4 pm Summary: The Registered Nurse (RN), Utilization Review , as an active member of the Middle Revenue Cycle and ... interdisciplinary care team, provides comprehensive Utilization Review to patients and families in...in an Acute Care Hospital Setting + Proficiency in utilization management and regulatory requirements preferred +… more
- Behavioral Center of Michigan (Warren, MI)
- Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination, implementation and reporting of complex ... clinical data and supports the operations of Samaritan Behavioral Center. The Utilization Review Coordinator reviews the patient's chart and records clinical… more
- Healthfirst (NY)
- …to maintain and improve department performance + Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement + Lead ... closely with other Operations leaders including but not limited to Care Management , Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams to… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and ... secure timely authorizations for hospital admissions and extended stays. The Utilization Review Coordinator monitors and documents all authorization activities,… 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, 8:00 AM - 5:00 PM **Webster, Texas, United States** 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