- Alameda Health System (Alameda, CA)
- …and a resolution is initiated and presented weekly at Medicare or Utilization Review meetings. **MININUM QUALIFICATIONS** : Education: Graduate of accredited ... school of nursing. Minimum Experience: Minimum one year clinical experience in a hospital, long term care facility, or other healthcare related facility. Preferred Experience: Previous experience as an MDS Coordinator; including completing Minimum Data Set… more
- UPMC (Pittsburgh, PA)
- …Prior Clinical Documentation Improvement (CDI) experience. + Background in Quality Assurance, Utilization Review , or Quality Insights. + Advanced knowledge of ... DRGs, PPS, and coding guidelines. + Familiarity with quality metrics and compliance standards. Key Skills + Excellent interpersonal and communication skills. + Analytical thinking and attention to detail. + Ability to work collaboratively across… more
- Wellpath (Valhalla, NY)
- …care through adherence to policies and procedures for admission and transfer, utilization review , and referrals. + Assumes responsibility and accountability for ... individual judgments andactions, andprovidesinput into mandatory committees as requested by superiors. **We are an Equal Employment Opportunity Employer** We are committed to fostering, cultivating, and preserving a culture of uniqueness. We celebrate a… more
- Sedgwick (Cincinnati, OH)
- …state and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. + Performs ... other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** Education and Licensing Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional… more
- CommonSpirit Health (Colorado Springs, CO)
- …closely with the RN Care Coordinator to coordinate care plans based on the utilization review activities performed by the RN Care Coordinator with compliance of ... federal, state and third party payers. The Social Worker will be required to participate in performance improvement initiatives related to appropriate patient care management and perform other departmental duties as assigned. The care team program improves the… more
- Northwell Health (Staten Island, NY)
- …and procedures. + Supervises clinical specialty pharmacy operations with Utilization Review Accreditation Commission (URAC) accreditation activities including ... medication preparation, dispensing, and supervision of pharmacy operations and personnel. + Assists in establishing, updating and maintaining the Pharmacy computer system and maintains all patient prescription charges, pharmaceutical supplies and controlled… more
- New York State Civil Service (Glens Falls, NY)
- …research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance counseling, pastoral counseling, or ... as a habilitation specialist or instructor of psychology.A practicum, externship, or clinical fieldwork assignment is defined as a direct clinical experience providing psychological services in a hospital, psychiatric hospital, psychiatric clinic, community… more
- Project Renewal, Inc. (New York, NY)
- …in the development and implementation of quality assurance management and utilization review + Participates in interdisciplinary meetings with shelter ... and housing staff for the assigned site to discuss high risk patients + Participates in quality improvement initiatives + Participates in community outreach programs as needed + Contributes to the overall functioning of the department + Maintains patient… more
- Cleveland Clinic (Dover, OH)
- …or AHA Certification by an approved entity + Two years of recent experience in utilization review , quality or care management + Knowledge of acute care and ... accreditation requirements + Experience in discharge planning and quality improvement **Physical Requirements:** + Requires normal or corrected hearing and vision to normal range. + Ability to perform work in a stationary position for extended periods. +… more
- Billings Clinic (Roundup, MT)
- …Responsibilities also include other services as assigned (eg, Pharmacy), utilization review /case management, discharge planning, orientation and training ... of staff, and trauma designation. (4)Develops, retains, recruits, and leads a talented team committed to accomplishing the goals and objectives of RMH.Recommends, implements, and evaluates plans and systems that assure a sufficient number of qualified and… more