- University of Pennsylvania (Philadelphia, PA)
- …academic programs outside of Penn and/or other academic project management responsibilities. Job Description Job Responsibilities 1. Provide executive-level ... all correspondence, written materials, documents are prepared in timely manner for review and distribution to meet all deadlines. Also ensures that all documents… more
- Northern Light Health (Unity, ME)
- …Quality Assurance, AOA and other governmental agencies. + Performs periodic review of established processes to assure staff understanding to identify opportunities ... Provider chart note completions + Assists with fiscal analysis and resource utilization for program development initiatives. + Ensures the approval process for… more
- MyFlorida (St. Petersburg, FL)
- …process billing claims. + Enters Services and tracking process for Directions Behavioral Health program, review clinical notes match claims and authorization. ... referrals in accordance to the established Specialty Care medical grid(Radiology, Behavioral and other specialties) + Verifies County eligibility. + Generates… more
- State of Colorado (Denver, CO)
- …throughout CMHHIFL. This position is required to regularly document in the behavioral electronic health record (BEHR) for treatment, quality assurance, and billing ... safety, and effectiveness. + Utilizes hospital-approved low-level and crisis management techniques across teams. Treatment is reviewed, changed, modified, and/or… more
- State of Colorado (Pueblo, CO)
- …also provides support to the Pack CARES team by participating in case review , documentation, and coordinated care efforts. This is a .83 FTE position intended ... needs from August through May. Primary Duties Non-Clinical Case Management + Provide case management services for...meetings and report progress related to student goals and utilization of resources. + Maintain repository of university and… more
- UnityPoint Health (Iowa City, IA)
- …services. * Is knowledgeable regarding managed care implications - precertification and utilization review procedures. * Assists with crisis services placement, ... patient staffing's and special care conferences. Assist with designated management duties in a leadership role. The patients served...where applicable. * Provides consultation regarding behavioral health issues as needed to other departments. *… more
- US Tech Solutions (Columbia, SC)
- …quality, cost effective outcomes. **Responsibilities:** + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services ... 1-2 weeks then remote training. + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise,… more
- Highmark Health (Columbus, OH)
- …and financial stakeholders **Preferred** + Experience with medical policy and utilization management functions + Medical coding experience **LICENSES or ... both internally developed and vendor-sourced criteria. This includes proactive monitoring, review , and timely updates in response to new evidence, regulatory… more
- Atlantic Health System (Summit, NJ)
- …assessment, including SDOH and multidisciplinary collaboration. 2. Ensures daily chart review , utilization reviews, coordination of discharge planning activities ... selected member populations across the continuum of illness. Ensures effective utilization and monitors health care resources. Manages the interdisciplinary team to… more
- HCA Healthcare (Brentwood, TN)
- …at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical ... patient flow, patient satisfaction, practice volume, billing and collections, service utilization , coding, physician and staff training + Have strategic and tactical… more