- HealthTrust Workforce Solutions (Bradenton, FL)
- …Case Managers to assure that the following functions of the role are completed: Utilization Review for medical necessity of admission and concurrent stay, Social ... and resource management, cost control, contract compliance, quality improvement, utilization management, denials management and management of relationships with… more
- Intermountain Health (Miles City, MT)
- …least five (5) years of nursing experience- Prior knowledge of managed care / utilization review **Physical Requirements:** Ongoing need for employee to see and ... + Help to identify strategies for reducing length of stay and appropriate utilization of services. + Utilize criteria including clinical pathway data and implement… more
- Trevecca Center for Rehabilitation and Healing (Nashville, TN)
- …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... the administrator in development of the annual budget. Appropriate and effective utilization of staff. Managing key operations and financial levers to achieve budget… more
- HCA Healthcare (Gainesville, FL)
- …and improve the patient flow program effectiveness as it relates to utilization review , resource management, and discharge planning and care coordination. ... hospitalists & PCP's to address and resolve issues related to facility utilization and patient flow process and facilitate strong working relationship between… more
- Highmark Health (Pittsburgh, PA)
- …with operational areas regarding issues related to supported technology. Manage utilization review , translation of foreign claims, coordination of benefits ... benefits/requirements/limits, discharge planning requirements, length of stay and resource utilization issues. + Adheres to the policies, procedures, rules,… more
- Penn Medicine (Plainsboro, NJ)
- …discharge planning and communicates plan clearly to patient, family and Utilization Review Nurse, Financial Counselor and outpatient treatment providers ... + Communicate effectively the essential clinical features of each case with utilization reviewers and monitors patient attendance in scheduled program and length of… more
- Calvary Hospital (Bronx, NY)
- …pertinent data. 8. Knowledge of and experience in Quality Assessment and Improvement, Utilization Review . 9. Ability to develop management systems to track data ... has been denied. Conducts interdepartmental meetings related to the quality and utilization of clinical services. Serves on various Hospital committees as assigned.… more
- University of Utah Health (Salt Lake City, UT)
- …education in healthcare or a related field. + One year of experience in a utilization review or case management environment. + Basic Life Support Health Care ... data collection. + Documents activities and progress in medical charts, computer billing/ utilization systems, or in other ways as directed. + Collaborates with… more
- Monte Nido (Eugene, OR)
- …continuity of care + Communicate with insurance providers for **pre-certification and utilization review ** + Collaborate on **discharge and aftercare planning** ... care. + Communicate with insurance companies for pre-certification and ongoing utilization management needs. + Participate in discharge planning and aftercare… more
- Rush University Medical Center (Chicago, IL)
- …the Division. The Care Management Navigator may contribute to transitional care planning, utilization review , and/or service line growth & outreach efforts for a ... a care management team that is responsible for promoting effective resource utilization to achieve an optimal clinical outcome. The Care Management Navigator applies… more
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