- Geisinger (Pottsville, PA)
- …professional determinations regarding medications and various drug interactions, drug utilization review , generic substitution, and accurately filling and ... dispensing the prescription. + Process prescriptions by receiving the prescription via telephone from the physician or in person from the patient, reviewing it against the medication profile for possible sensitivities and drug interactions, and checking it for… more
- Dana-Farber Cancer Institute (Boston, MA)
- …directs and oversees a team responsible for patient care coordination, including utilization review , intake or discharge planning, and managed care contracting. ... This role ensures the delivery of high-quality patient care by developing and implementing nursing policies, procedures, and best practices. The Director leads and mentors a diverse team of nursing professionals, fostering their professional growth and… more
- Truman Medical Centers (Kansas City, MO)
- …supervision above the first supervisory level. + Awareness of trends in utilization review and governmental third party payer reimbursement policies, standards ... and procedures. + Knowledge of standard problem solving, management information systems and governmental and third party payer billing information requirements. + Written and verbal communication skills to maintain effective working relationships with patients… more
- CVS Health (Scottsdale, AZ)
- …your understanding of patient safety and error prevention, quality assurance drug utilization review (DUR), pharmacy professional standards such as corresponding ... responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that pharmacy operations run smoothly, our patients' prescriptions are filled promptly, safely, and accurately, and we are providing caring service that… more
- Catholic Health (Kenmore, NY)
- …(2) years acute care and/or community health nursing + Preferred prior insurance /managed care/ utilization review experience in the role of a Case Manager or ... Disease Manager, Population Health, Discharge Planning or Chronic Care Manager KNOWLEDGE, SKILL AND ABILITY + Possesses case management skills critical to working on an interdisciplinary team + Has a good understanding of the Social Determinants of Health… more
- Accura Healthcare (Shell Rock, IA)
- …and personalizing assessments for use in the evaluation of quality of care and utilization review for the purpose of clinical reimbursement. The MDS Coordinator ... confers with physicians, nurses, and other health personnel to ensure complete, current, and accurate medical records. QUALIFICATIONS: + Current licensure as a Licensed Practical Nurse (LPN) in the applicable state, without restrictions, and/or ability to… more
- MTC (San Diego, TX)
- …Functions:** 1. Performs complex technical assistance work; implements quality assurance utilization review procedures; and responds to inquiries regarding ... technical program and administrative rules, regulations, policies, and procedures. 2. Assists in monitoring, reviewing, interpreting, and evaluating quality of services; assists in compiling and analyzing data and preparing reports; and makes recommendations… more
- Intermountain Health (Park City, UT)
- …patient experience and all aspects of the Intermountain Operating Model. Participates in utilization review audits. + **Meetings** : Participates in patient care ... conferences, interdisciplinary meetings, staff meetings, and necessary professional and work groups in collaboration/consensus with leader. + **Program Development and Marketing** : Contributes to program development and marketing strategies to grow the… more
- Intermountain Health (St. George, UT)
- …+ Case Management Certification + Demonstrated experience in case management, utilization review , value-based care, and/or discharge planning. + Basic ... computer skills, including proficiency in word processing and spreadsheet software. Intermediate knowledge of word processing and Excel software. **Physical Requirements:** **Physical Requirements** + Ongoing need for employee to see and read information,… more
- Accura Healthcare (Shell Rock, IA)
- …personalized assessments for use in the evaluation of quality of care and utilization review for the purpose of clinical reimbursement. Confer with physicians, ... nurses, and other health personnel to ensure complete, current, and accurate medical records. QUALIFICATIONS: + Hold current Registered Nurse (RN) license with applicable state, without restrictions, and/or ability to obtain a state-specific license. +… more