- Avera (Mitchell, SD)
- …as needed by the Pharmacy Department and applicable accreditations such as Utilization Review Accreditation Commission, Joint Commission, NIOSH, OSHA, or other ... accreditations as may be required by law, practice standards, or departmental policy to maintain compliance with accreditation entities. + May be responsible for assisting customers on the phone or in person. + May run reports and use the automated dispensing… more
- UnityPoint Health (Cedar Rapids, IA)
- …Maintains current knowledge of behavioral managed care and the precertification and utilization review activities necessary to obtain treatment approval. * ... Provides statistical data or special reports as required by Substance Use Disorder Services department. Development & Patient Education * Continues professional development and involvement in professional activities that enhance clinical practice by sharing… more
- NHS Management, LLC (Mobile, 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 nursing and other therapeutic procedures to other level professionals and paraprofessional associates. + Makes regular patient rounds to observe and assess… more
- HCA Healthcare (San Antonio, TX)
- …+ Participates in developing department goals/objectives and clinical programming. Performs utilization review as assigned. + Assists with Process and ... Quality Improvement initiatives. + Performs other duties as assigned. + Practices and adheres to the "Code of Conduct" and "Mission and Value Statement." **What qualifications you will need:** + Masters Degree in Social Work or related field required. + Basic… more
- Fairview Health Services (Minneapolis, MN)
- …may include prior authorizations, vacation supplies, dose changes, price check and drug utilization review . + Process new and refill prescriptions in the ... computer system quickly and accurately; including entering refill authorization requests and entering and calculating complex prescriptions such as compounds and injectables. + Demonstrate comprehensive knowledge of the computer system. Utilize the reporting… more
- UnityPoint Health (Cedar Rapids, IA)
- …+ Is knowledgeable regarding managed care implications - precertifications and utilization review + Maintains competence in performing procedures involved ... with the management of violent or potentially violent patients. Complies with policies for restraint and seclusion per service guidelines. Qualifications + Current licensure in good standing to practice as a licensed practical nurse in the state of Iowa. +… more
- Dignity Health (Long Beach, CA)
- …when appropriate, discharge planning activities, and coordination with the multidisciplinary team/ Utilization Review Case Manager for referral to a CCS-paneled ... provider or CCS Medical Therapy Unit for patients who may continue to require Occupational Therapy services after hospital discharge. **Job Requirements** _Level I:_ + No prior experience required. _Level II:_ + Minimum one year experience as an Occupational… more
- NHS Management, LLC (Huntsville, 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 nursing and other therapeutic procedures to other level professionals and paraprofessional associates. + Makes regular patient rounds to observe and assess… more
- Sedgwick (Irving, TX)
- …updates or changes with internal departments. + Provides referrals to legal, utilization review , pharmacy, and Special Investigations Unit (SIU) as appropriate ... and coordinates independent medical examinations. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** **Education & Licensing** High school diploma or GED… more
- Elevance Health (Denver, CO)
- …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 ... military base, vessel or any embassy located in or outside of the US, unless they are command-sanctioned activities. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and… more