- 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 ... using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal clinical denials related to the care provided to… 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 ... using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal clinical denials related to the care provided to… more
- Saint Luke's (Kansas City, MO)
- …for assuring the receipt of high quality, cost efficient medical outcomes through utilization review and management . This position includes monitoring ... stay, using clinical guidelines (InterQual). + Complies with CMS regulation regarding utilization review / management . + Obtains and manages insurance… 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
- 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 ... care to MCC in response to physician order, or review of updated clinical information + Acts as a...current with industry standards and business objectives related to Utilization and Care Management as appropriate. +… more
- WMCHealth (Valhalla, NY)
- …in the implementation or investigation of the procedures specified in the Quality Management , Utilization Review and Discharge Planning Program at ... care agency, one of which must have been in the area of utilization review , quality assurance, risk management or discharge planning. About Us: Westchester… more
- WMCHealth (Valhalla, NY)
- …in the implementation or investigation of the procedures specified in the Quality Management , Utilization Review and Discharge Planning Program at ... care agency, one of which must have been in the area of utilization review , quality assurance, risk management or discharge planning. About Us: Westchester… more
- Prime Healthcare (North Las Vegas, NV)
- … utilization review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone ... and more. For more information, please visitwww.northvistahospital.com. Responsibilities The Utilization review tech essentially works to coordinate the… 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 ... records, as assigned to caseload. Actively participates in Case Management and Treatment Team meetings. Serves as on-going educator...Health and Human Services field is highly preferred. 2. Utilization Review experience is highly preferred. 3.… 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