- WestCare Foundation (Fresno, CA)
- …meetings and presentations with referral agencies. * Implement Quality Assurance and Utilization Review systems that monitor the effectiveness of the program. ... * Assist in the development of program fiscal and budgetary tracking systems and implementation as well as providing the oversight and management of operating budget and program fiscal expenditures. * Monitor compliance with all required standards,… more
- Bozeman Health (Bozeman, MT)
- …and transfer of patients, appropriately guiding physician understanding of admission Utilization Review InterQual criteria + Facilitate and communicate the ... need for emergency surgery with OR and procedural areas + Initiate and facilitate hospital organ donation protocols + Round on all nursing units monitoring activities: + Assure adequate staffing with knowledge of patient needs and unit standards, assist in… more
- NHS Management, LLC (Vestavia Hills, AL)
- …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. + Receives physicians' instructions regarding resident ... care and ensures that orders are transmitted to other units as needed. + Oversees delegation of simple nursing and other therapeutic procedures to other level professionals and paraprofessional associates. + Makes regular patient rounds to observe and assess… more
- CVS Health (Kalamazoo, MI)
- …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
- University of Utah (Salt Lake City, UT)
- …thrombosis, addiction medicine, global/rural health, palliative care, informatics, ethics, and utilization review + Highly flexible scheduling + Extensive ... mentoring and opportunities to participate in QI and scholarship on the local, regional, and national levels + Competitive pay and excellent benefits **Minimum qualifications:** Medical degree, eligible for Utah Medical License, and ABIM eligible **Preferred… more
- Monte Nido (Waltham, MA)
- …regulatory agencies. + Conduct psychosocial assessments, participate in treatment planning, utilization review , and discharge planning. + Conduct individual, ... group and family therapy. + Conduct risk assessments and crisis management. + Manage cases for primarily the adolescent population with an expectation of some coverage in the adult programs. + Collaborate with referral sources and outpatient providers. + Work… more
- Rising Medical Solutions (Los Angeles, CA)
- …nursing, medical case management, occupational health, orthopedics, home health care, utilization review , or quality assurance + Familiarity with regional ... physicians + CCM, and COHN-S/CM are optional but highly valued + Ability to drive to appointments within a 2-hour radius + Active, unencumbered registered nursing license with a minimum of 5 years' experience Benefits + Opportunity to make a difference in… more
- 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