- CVS Health (Harrisburg, PA)
- …and English **Preferred Qualifications** + Crisis intervention skills preferred Managed care/ utilization review experience preferred + Case management and ... discharge planning experience preferred + Managed care/ utilization review experience preferred **Education** Masters Degree in Social Work or Counseling required… more
- HCA Healthcare (Nashville, TN)
- …treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile ... for patients in regard to managed care organizations + Conducts utilization review for managed care cases in admissions/intake department + Willingness to… more
- Ochsner Health (New Orleans, LA)
- …3 years of hospital-based experience in discharge planning, case management or utilization review . **Certifications** Required - Current registered nurse license ... knowledge of the conditions of participation as it relates to utilization review and discharge planning. + Maintains open communication with all appropriate… more
- CVS Health (Salt Lake City, UT)
- …English **Preferred Qualifications** + Crisis intervention skills preferred + Managed care/ utilization review experience preferred + Case management and ... discharge planning experience preferred + Discharge planning experience + Utilization review , prior authorization, concurrent review , appeals experience +… more
- Community Health Systems (Tucson, AZ)
- …and administration of the activities of clinical review , discharge planning, resource utilization and utilization review . Acts as a liaison between ... to assess the appropriateness of admission, continued hospital stay, and utilization of diagnostic services. + Collaborates with interdisciplinary teams (IDT) to… more
- Sutter Health (Roseville, CA)
- …and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of ... care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely… more
- University of Miami (Miami, FL)
- … of oncology and non-oncology therapy. Responsibilities: + Collaborate with Utilization Review Department and providers to ensure clinically appropriate, ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Reimbursement Pharmacist… more
- Health Care Service Corporation (Chicago, IL)
- …reviews in accordance with the medical contract and regulations, medical criteria, utilization review , and quality of care. **JOB REQUIREMENTS** **:** + ... not required to obtain multi-state licenses. **PREFERRED JOB REQUIREMENTS** **:** + Utilization review or utilization management experience **Telecommute:**… more
- UCLA Health (Santa Monica, CA)
- …of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital ... teams + Knowledge of a large university teaching hospitals Preferred: Strong Utilization Review experience and understanding of CMS and other regulatory… more
- YesCare Corp (Philadelphia, PA)
- …Engage in all quality improvement initiatives, including sentinel event reviews. + ** Utilization Review :** Participate actively in utilization review ... justifications for non-formulary medication requests when necessary. + **Resource Utilization :** Resolve patient care issues using in-house resources before… more