- Queen's Health System (Honolulu, HI)
- …* Experience with EMRs (preferably Epic), insurance verification tools, and utilization review processes. * Excellent interpersonal and communication skills. ... Provides patient access services and coordinates referral workflows and utilization tracking. Performs scheduling, registration, insurance verification, and financial… more
- Elevance Health (WA)
- …or equivalent. Requires a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN or ... in multiple states. **Preferred Skills, Capabilities and Experiences:** + Utilization Management and/ore Case Management experience strongly preferred. + Post… more
- Kaleida Health (Buffalo, NY)
- …In addition to daily oversight of operations, the VP will partner with Utilization Review , Revenue Cycle, and Clinical leadership to create patient/family ... preferred. RN licensure required.** **Experience** **10 years of care management/ utilization management experience required in hospital and/or ambulatory settings. 7… more
- HCA Healthcare (Wichita, KS)
- …years of critical care experience preferred + Certification in case management or utilization review preferred + InterQual experience preferred **For more than ... and compliance with case management regulatory guidelines per CMS. + Manages VPro utilization for case management vendors + Assists in setting up new employees with… more
- Henry Ford Health System (Detroit, MI)
- …Proficiency with computers, electronic health records (EHR), database systems, and utilization review /case management documentation systems. + Knowledge of CMS, ... resources to optimize patient outcomes and promote efficient resource utilization . Key Responsibilities: Clinical Care Coordination: + Conduct comprehensive patient… more
- FLACRA (Penn Yan, NY)
- …within the timelines outlined by FLACRA. + Participates in quality initiatives and utilization review activities as requested. + Strives to understand and meet ... the fiscal and financial parameters of practicing in the health care environment. + Provide administrative and/or clinical supervision to clinic staff as appropriate and in collaboration with clinic director. + Provides educational presentations and… more
- Catholic Health Initiatives (Omaha, NE)
- …regulations pertaining to their practice. Performs other duties as assigned, including utilization review as necessary. **Job Requirements** Graduate of an ... multidisciplinary team to ensure progression of care and appropriate utilization of inpatient resources using established evidence based guidelines/criteria.… more
- Community Health Systems (Hattiesburg, MS)
- …clinical nursing experience required + 3-5 years of experience in care management or utilization review required + 1-3 years of leadership experience in a ... + Refers cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ensures appropriate follow-up. + Identifies avoidable days and… more
- Calvary Hospital (Bronx, NY)
- …identify the expected length of stay (ELOS). The RNCM participates in the Utilization Review , Discharge Planning, Risk Management, and Quality Assessment and ... Qualifications: + Five (5) or more years experience in either Utilization Management, Quality Assessment and Improvement, Risk Management, and/or Discharge Planning… more
- Sharp HealthCare (San Diego, CA)
- …with 0-2 errors; Have the ability to proof work.Knowledge of insurance, utilization review , scheduling requirements and support of front desk ... meet service standards. Follows policy and procedure for entering of OCM and utilization of IDX. Completes work within assigned hours.Able to respond to changing… more
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