- Hartford HealthCare (Southington, CT)
- …The individual in this role provides clinical staff with guidance on documentation, utilization , and patient care decisions to support optimal clinical and ... and grow within our organization, all while providing integrated support to the patient. As part of Hartford HealthCare,...operational outcomes. They review visit utilization for care appropriateness and collaborate with clinicians on… more
- University of Southern California (Arcadia, CA)
- …outside referring physicians andmedical groups.* Communicates with insurance company utilization review and authorization personnel.* Gathers and maintains data and ... Quality ReviewDepartment/Hospital Administration.* Acts as a resource person for nurse coordinators, nursing, and other hospital staff.* Reviews, interprets,… more
- Hartford HealthCare (Mansfield Center, CT)
- …The individual in this role provides clinical staff with guidance on documentation, utilization , and patient care decisions to support optimal clinical and ... to improve OASIS accuracy and care quality, recommending cost-effective corrections that support clinical and operational goals. Reviews visit utilization for… more
- Philips (Salt Lake City, UT)
- **Sales Support , Clinical Specialist - FORS (West/National Travel)** In this role as **Clinical Specialist** , you will play a pivotal role in the introduction and ... lift barriers. + Provide clinical and technical product expertise, in-lab product support and educate the end-users, in order to maximize the product's performance… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …of risk areas and concerns that may require additional attention. + Partner with Utilization and Care Management to provide clinical support and analysis on ... uses clinical expertise and technology together to develop and support strategies to manage the increasing cost of health...of a member's course of illness, history of service utilization and costs incurred. + Analyze provider utilization… more
- Baystate Health (Springfield, MA)
- …based on clinical relevance, with integration of care management skills to support organizational fiscal goals. Supports the patient throughput assistant in daily ... on admission to identify level of care, potential need for practice guideline utilization , to determine the anticipated LOS and anticipated care needed for each… more
- Hartford HealthCare (Southington, CT)
- …The individual in this role provides clinical staff with guidance on documentation, utilization , and patient care decisions to support optimal clinical and ... that support clinical and operational goals. * Reviews visit utilization for appropriate patient care, collaborates and consults clinicians on needed… more
- Ventura County (Ventura, CA)
- …+ Benefits + Questions Description Are you a licensed Psychiatric Technician or Vocational Nurse in California looking to make a real difference in the lives of ... and Per Diem Senior Psychiatric Technician are represented by the California Nurse 's Association (CNA) and are eligible for overtime compensation. NOTE: Salary… more
- Fallon Health (Worcester, MA)
- … Nurse in a clinical setting required. * 2 years' experience as a Utilization Management/Prior Authorization nurse in a managed care payer preferred. * One ... Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The PA Nurse uses a multidisciplinary approach to review service requests (prior-authorizations),… more
- UNC Health Care (Smithfield, NC)
- …Summary: The purpose of this position is to provide ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation ... and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Care Manager must be highly organized… more