- STG International (Victorville, CA)
- …patient safety. *Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health ... of Quality Performance Improvement Team (QPIT) strategic initiatives. *Participate in review and improvement of clinical success in of areas of responsibility.… more
- YesCare Corp (Philadelphia, PA)
- …including sentinel event reviews and chart audits. + Engage actively in the Utilization Review process, ensuring appropriate use of healthcare resources. **Key ... + Provide and ensure on-call services to support patient care needs. + Review and approve clinical protocols, policies, procedures, and the medical disaster plan… more
- Elevance Health (Norfolk, VA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians.… more
- Baylor Scott & White Health (Dallas, TX)
- …related education to others such as allied health professionals, Administration, Utilization Review , Comprehensive Care specific to documentation and its ... documentation of medical conditions and treatment in patient records. Performs review of record to determine complete, accurate documentation of patient condition… more
- Catholic Health Initiatives (College Station, TX)
- …when required, obtaining pre‐certification reference number, approved length of stay, and utilization review company contact person and telephone number **Job ... regarding their third‐party coverage, financial responsibility, and billing procedures Review patient account summaries of unbilled charges, billing, payments, and… more
- Insight Global (New York, NY)
- …preferred - 5-6+ years of clinical practice can be flexible - 1+ years of utilization review experience in a managed care plan (health care industry) - Licensed ... Physician Reviewers for a leading health insurance company. The Physician Reviewer will review requests for care before, during, and after treatment to confirm they… more
- STG International (Auburn, NY)
- …safety. * Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... of Quality Performance Improvement Team (QPIT) strategic initiatives. * Participate in review and improvement of clinical success in of areas of responsibility. *… more
- Elara Caring (Dallas, TX)
- …Identifies and reports potential payment/coverage problems. + Supervises and coordinates utilization review activities. + Participates in strategic development ... of Key Accounts, including participation in weekly, monthly, and quarterly review meetings, as needed. + Ensures accuracy of all public information, materials, and… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- …+ Prepares and/or reviews reports, medical records and correspondence; + Perform utilization review and management functions; + Attends court hearings as ... training are most aligned with the role. To prepare, review this helpful Interview Preparation Guide to make the...recruitment updates, please check your Personal Status Board and review our Frequently Asked Questions. If you have additional… more
- University of Miami (Miami, FL)
- …via in-basket messaging. + Extensive collaboration with providers, nursing unit, and utilization review department in coordinating admissions. CTU + Must possess ... to apply for a faculty or staff position, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Core Job Summary:… more