- Whitney Young Health Center (Albany, NY)
- …to continually assess and improve the quality of patient services-conducts monthly utilization review . + Participates in the recruitment of clinical staff. ... + Facilitates a multidisciplinary integrated team approach to the provision of clinical treatment services. + Demonstrates excellence in both internal and external customer service. + Understands and is able to effectively communicate HIPAA compliance,… more
- Deloitte (Los Angeles, CA)
- …nurse, physician, physician assistant, case manager, clinical documentation specialist, utilization review , informatics RN, Quality, DRG Validation and ... health IT preferred + Knowledge of Medicare reimbursement system and coding structures preferred + In-depth knowledge and experience in medical terminology, medical coding, and ICD-10-CM/PCS, IPPS payment system is a plus' + Experience in quality measurement,… more
- Fairview Health Services (Hibbing, 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 sophisticated prescriptions such as compounds and injectables. + Demonstrate extensive knowledge of the computer system. Utilize the reporting… more
- Sedgwick (Naperville, IL)
- …and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **QUALIFICATIONS ... AND LICENSING** **Education & Experience** Bachelor's degree from an accredited college or university preferred. **Experience** Four (4) years of claims management experience or equivalent combination of education and experience required. _As required by law,… more
- Intermountain Health (Brighton, CO)
- …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. **Minimum Qualifications:** + Current Physical Therapist license in states where you work. + Current BLS certification endorsed by… more
- Washington County Hospital and Clinics (Washington, IA)
- …documentation of provider activities to provide statistics to the Medical Record Utilization Review Committee regarding any deficient and delinquent providers in ... compliance with hospital bylaws and federal agency regulations. + Prepare statistical reports for the Iowa Hospital Association on a quarterly basis by collecting and summarizing medical care and census information, such as types of diseases treated, surgery… more
- Massachusetts Institute of Technology (Cambridge, MA)
- …patients, families, providers, and community agencies. PREFERRED: two years of case management, utilization review , and discharge planning experience. 11/18/2025 ... Registered Nurse, Care Coordinator + Job Number: 25320 + Functional Area: Health Care + Department: MIT Health + School Area: Executive Vice President + Pay Range Minimum: $95,000 + Pay Range Maximum: $105,000 + Employment Type: Full-Time + Employment… more
- Emory Healthcare/Emory University (Peachtree City, GA)
- …participate in facility meetings as directed by Center Manager (may include utilization review , infection control, disaster preparedness, etc.). + Communicate ... pertinent patient information to referring physicians, staff, employers, insurance carriers and rehabilitation specialists. Provide injured worker with guidelines for job modification and energy conservation in accordance with physician + Custom fabricate… more
- Tenet Healthcare (Detroit, MI)
- …universities. Assists management in department functions and special projects, ie, utilization review , quality assurance, program development and committee work. ... Conducts studies and research projects as requested. Performs all the duties/responsibilities of a Physical Therapist, as required. Qualifications : 1. Bachelors degree in Physical Therapy or a certification in Physical Therapy from an accredited program. 2.… more
- University of Colorado (Aurora, CO)
- …related to the delivery of medical care and clinical services such as utilization review , quality assurance, and medical protocol development. + Assist in ... the organization and co-directing ATDC annual Keystone conference. + Oversee the activities of group physicians and other providers, including the recruiting and credentialing processes. + Develop a transition program from pediatric to adult clinic for ongoing… more