- Community Health Systems (Franklin, TN)
- **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and appeals ... timely authorizations for hospital admissions and extended stays. The Utilization Review Coordinator monitors and documents all authorization activities, assists… more
- University of Utah Health (Salt Lake City, UT)
- …advancement, and overall patient outcomes. **Responsibilities** + Applies approved utilization criteria to monitor appropriateness of admissions with associated ... or third-party payer. + Alerts and discusses with physician/provider and case manager /discharge planner when patient no longer meets medical necessity criteria for… more
- Abbott (Plymouth, MN)
- …+ Manage field device demo needs, tracking sales & patient resource utilization , and working with communications manager to manage promotional collateral. ... people in more than 160 countries. **Senior Product Marketing Manager - TAVR** **Working at Abbott** At Abbott, you...**WHAT YOU'LL WORK ON** + The Senior Product Marketing Manager - TAVR, will lead downstream marketing efforts while… more
- Cleveland Clinic (Cleveland, OH)
- …of the most respected healthcare organizations in the world. As a Utilization Management Specialist, you will perform UM activities, such as admission, concurrent, ... requirements.** A caregiver who excels in this role will: + Recommend resource utilization . + Prioritizes and organizes work to meet changing priorities. + Utilizes… more
- BayCare Health System (St. Petersburg, FL)
- …dignity, respect, responsibility and clinical excellence. **The Team Lead Utilization Review responsibilities include:** + Directing and coordinating the daily ... + This position will report to the hospital based Manager and support the goals and policies of the...3 years of Case Management or 3 years of Utilization Management or 6 years of clinical nursing **Certifications… more
- Providence (Mission Hills, CA)
- **Description** Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records ... strong clinical background combined with well-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination. The … more
- Saint Francis Health System (OK)
- …in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers the details of ... issues and participate in treatment teams, Patient Care Committee, and the Utilization Review Staff Committee by providing data and contributing to the improvement… more
- Hackensack Meridian Health (Edison, NJ)
- …and serve as a leader of positive change. The **Care Management, Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay,… more
- CareFirst (Baltimore, MD)
- …& Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health ... to facilitate department functions + Communicates in a timely manner to Manager appropriate information including, but not limited to, customer/case issues, reports,… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions as the ... necessity of outpatient observation and inpatient stays and the utilization of ancillary services + Perform other duties as...+ Preferred ACM (Case Management) + Preferred CCM (Case Manager ) **Education:** + Required Associates in Nursing or +… more