- Virtua Health (Pennsauken, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... UR Tech and AA to support UR and revenue cycle process.Position Responsibilities: Utilization Management* Utilizes Payer specific screening tools as a resource to… more
- PeaceHealth (Eugene, OR)
- **Description** PeaceHealth is seeking a RN Admissions Coordinator/ Utilization Review - Psychiatric Unit for a Per Diem/Relief, 0.00 FTE, Variable position. The ... with patients, families, referring facilities, physicians, emergency departments' crisis workers , public safety officers, outside agencies and Behavioral Health… more
- Trinity Health (Syracuse, NY)
- … is a key stakeholder in the emergency room care transition team which includes nurse case managers, utilization review nurses, providers, and etc. whom all ... social work. Licensed to practice as a Licensed Clinical Social Worker (LCSW) OR Licensed Master Social Worker ( LMSW) through the State of New York Participates… more
- Centene Corporation (Phoenix, AZ)
- …Tempe and/or Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care to members. ... within utilization management. + Oversees the behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines +… more
- Molina Healthcare (GA)
- …performance of one or more of the following activities: care review , care management, utilization management (prior authorizations, inpatient/outpatient medical ... Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family… more
- Prime Healthcare (Inglewood, CA)
- …managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Additionally, ... to lead our dynamic Case Management Team consisting of Registered Nurses, Social Workers , and Clinical Coordinators. This leader will oversee all facets of … more
- Molina Healthcare (GA)
- … Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family ... services professionals in some or all of the following functions: utilization management, care management, behavioral health and other programs. Leads team… more
- Humana (Frankfort, KY)
- …Counselor **(LPC)** + Psychologist **(PhD)** **Preferred Qualifications** + Experience with utilization review process + Outpatient Behavioral Health experience ... of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills… more
- Prime Healthcare (Chino, CA)
- …for its quality, including as among the 100 Great Community Hospitals by Becker's Hospital Review in 2018 and as among the 100 Top Hospitals by IBM Watson Health. ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum… more
- Zurich NA (Schaumburg, IL)
- …and medical terminology Preferred Qualifications: + 2 or more years' experience in Utilization Review , Case Management, Workers Compensation, or medical bill ... Medical Bill Review Senior Nurse 127127 Zurich Insurance is currently looking for a **Medical Bill Review Senior Nurse ** to work from our Schaumburg, IL… more