- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors ... of approvals from insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use of hospital… more
- UNC Health Care (Rocky Mount, NC)
- …and cost-efficient care of patients through such case management functions as utilization review and discharge planning. May facilitate the execution of ... reviews for private insurance companies, Medicare and Medicaid, in accordance with utilization review guidelines. Tactfully and effectively informs Manager of… more
- International Medical Group (Indianapolis, IN)
- …efficiency of the use of health care services, procedures, and facilities for utilization review and /or /evacuation/repatriation. Work as a liaison between the ... Word and Excel. PREFERRED SKILLS + BSN Preferred + Minimum two years utilization review with a managed care or insurance company + Proficient verbal and written… more
- Sutter Health (San Francisco, 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
- HCA Healthcare (Sanford, FL)
- …is preferred + BSN is preferred + Certification in Case Management, Nursing or Utilization Review is preferred HCA Florida Lake Monroe Hospital is a 221-bed ... supporting a balance of optimal care and appropriate resource utilization . You would be part of a phenomenal team...apply for our RN Case Manager opening. We promptly review all applications. Highly qualified candidates will be directly… more
- Baylor Scott & White Health (College Station, TX)
- …coordinating patient care across the continuum to include case management, social work, utilization review and care coordination to achieve optimal clinical and ... FACTORS** Knowledge of care coordination, discharge planning, case management and utilization review . Knowledge of human behavior and performance; individual… more
- Texas Health Resources (Dallas, TX)
- …available resources. Assesses patient information utilizing psychological and medical knowledge. Utilization Review and Management * Performs effective ... utilization review according to department identified criteria to determine the appropriate utilization of resources and patient level of care. Reviews daily… more
- Charter Care Health Partners (North Providence, RI)
- …a specific patient population. Performs functions related to Patient Advocacy; Utilization Review ; Resource Management; Continuum of Care Management (Discharge ... that includes recent experience with case management, patient navigation, case management, utilization review or discharge planning is strongly preferred. Must… more
- Charter Care Health Partners (North Providence, RI)
- …a specific patient population. Performs functions related to Patient Advocacy; Utilization Review ; Resource Management; Continuum of Care Management (Discharge ... that includes recent experience with case management, patient navigation, case management, utilization review or discharge planning is strongly preferred. Must… more
- ChenMed (Miami, FL)
- …experience in Hospital medicine preferred + At least one (1) year of utilization review experience preferred **PAY RANGE:** $198,797 - $283,995 Salary **EMPLOYEE ... our team. The Physician Reviewer is the primary physician reviewer for Utilization Management/Clinical Appropriateness review cases in our organization. Other… more