- SUNY Upstate Medical University (Syracuse, NY)
- …including PC, Windows, Microsoft applications, Zoom/WebEx platforms, etc. Preferred Qualifications: Utilization management or utilization review experience, ... with reimbursement entities. This is achieved through a thorough chart review and utilization of first-level screening criteria to ensure patients are at the… more
- Houston Methodist (Houston, TX)
- …resources. This position is a key member and leader of the hospital's utilization review /management committee, which is charged with regulatory goals of ensuring ... of care, length of stay, and quality issues. + Chair the utilization review /management committee, actively participates in defining operational strategic… more
- Nuvance Health (Danbury, CT)
- …for providing strategic leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff ... *System Care Coordination Leader* will be responsible for leading a team encompassing utilization review and denials/appeals specialists and will need to foster… more
- Tenet Healthcare (Detroit, MI)
- …provisions and provides interpretation of department policies, in accordance with the DMC Utilization Review Plan. Identifies the need for and drafts or defines ... to ensure timely referral, follow up and documentation. Implements and monitors utilization review process in place to communicate appropriate clinical data to… more
- Ventura County (Ventura, CA)
- …+ Experience with managed care + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review systems and programs + At ... with managed care + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review systems and programs + Direct patient… more
- Virginia Mason Franciscan Health (Burien, WA)
- …medical staff and take on the role as leader of the Hospital's utilization review /management committee, which is charged with adhering to regulatory requirements ... as needed * Reviews medical records of patients identified by case managers/ utilization review nurses, or as requested by other members of the healthcare team,… more
- Brockton Hospital (Brockton, MA)
- …delays through problem resolution and follow-up. Monitors on-site case managers and utilization review staff to ensure compliance with Signature Healthcare ... management experience Proven experience in coordinating discharge planning and utilization review experience required. Prior management experience required.… more
- Catholic Health Initiatives (Lexington, KY)
- …training sessions. + Participates in the Case Management Process including Utilization Review and Proactive Discharge Planning. Articulates case management ... availability for rounds and / or other daily case management and utilization review activities. Ensures that physicians covering the PA are familiar with the… more
- Corewell Health (Dearborn, MI)
- …patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). + ... years of relevant experience Three to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + Registered… more
- Covenant Health Inc. (Knoxville, TN)
- …and financial data to various audiences as necessary. + Completes daily work lists for utilization review meeting the time frames set forth by Covenant Health. + ... Responsibilities + Reviews providers' requests for services and coordinates utilization management review . + Reviews precertification requests for… more
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