- The County of Los Angeles (Los Angeles, CA)
- …OPTION I:One year of experience performing the duties of a Utilization Review Nurse* or Medical Service Coordinator , CCS.** -OR- OPTION II: Two (2) ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...In the County of Los Angeles, a Medical Service Coordinator , CCS (https://www.governmentjobs.com/careers/lacounty/classspecs/1065117) determines medical eligibility of children referred… more
- Tenet Healthcare (Detroit, MI)
- …of care and appropriate level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. (5% daily, ... RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse… more
- Health Care Service Corporation (Albuquerque, NM)
- …decision making skills.** **PC and database experience.** **PREFERRED JOB REQUIREMENTS:** ** Utilization review experience.** **3 years clinical experience in ... Summary** This position is responsible for ensuring accurate and timely clinical review of behavioral health cases (Applied Behavior Analysis (ABA)) for medical… more
- St. Bernard's Medical Center (Jonesboro, AR)
- …appropriateness by collaborating with MD, Patient Placement Coordinator , and Utilization Review Coordinator . Complies with guidelines, institutional ... policies and procedures, and other information to determine appropriate transfers and admissions into Medical Center, Emergency Department, and St. Bernards Behavioral Health. more
- University of Utah Health (Salt Lake City, UT)
- …and trust that are integral to our mission. EO/AA_ + The Staff Utilization Coordinator is responsible for providing healthcare operational support services, ... Timekeeping team. + Collaborating closely with Nursing Leadership, the Staff Utilization Coordinator reviews and develops schedules based on agreed-upon… more
- South Middlesex Opportunity Council (Framingham, MA)
- …individuals, children and families. This position will coordinate billing and monitor utilization review for the Clinic and Residential Recovery Programs. ... fashion, for the RRS and outpatient clinic programs. + Review denials and partially paid claims and resolve discrepancies....As part of the responsibilities of this position, the Utilization Management Coordinator will have direct or… more
- Integra Partners (Troy, MI)
- The UM Coordinator assists and supports the clinical team (UM Nurses/Medical Director) with administrative and non-clinical tasks related to processing ... Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES +...RESPONSIBILITIES + Monitor incoming faxes + Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS… more
- Saint Francis Health System (Tulsa, OK)
- …participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of ... support to the hospital and treatment team throughout the review of patients, their placement in various levels of...and benefits of patients, matching the level of care utilization . Assures compliance with Managed Care Behavioral Health standards… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of...its regulations may be referred to the Title IX Coordinator , to the Department of Education, Office for Civil… more