- Hackensack Meridian Health (Hackensack, NJ)
- The Utilization Review Physician collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical ... Hackensack University Medical Center. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- Sutter Health (Sacramento, CA)
- …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Some awareness ... health care services. The PA will develop expertise on matters regarding physician practice patterns, over- and under- utilization of resources, medical… more
- CVS Health (Oklahoma City, OK)
- …psychiatrist. * Experience with managed care, as a provider and manager of care utilization review or physician advisor experience. * Child/Adolescent Board ... Medical Director (Behavioral Health), you will: * Provide leadership and day-to-day physician oversight for utilization management team, including the management… more
- Billings Clinic (Billings, MT)
- …and coordinates care with the RN Care Manager, Social Services Care Manager, Utilization Review RN, Physician Advisor and Care Management Assistant. ... here. About Us Billings Clinic is a community-owned, not-for-profit, Physician -led health system based in Billings with more than...high risk for readmission. * Interfaces effectively with the Utilization Review department to stay current on… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE ... see comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're… more
- The County of Los Angeles (Los Angeles, CA)
- …Organization guidelines and the Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...by subordinate supervisors on number and status of reviews, physician advisor referrals, and type of physician … more
- Commonwealth Care Alliance (Boston, MA)
- …Group **Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director ... our rapidly growing membership. The incumbent will have significant experience with utilization review , ideally experience with public programming, and excellent… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... this position is able to cover a multitude of utilization review functions through point of entry,...process improvements). **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates with the physician and all members of the interprofessional health care… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.Thisis a full-time role. *Purpose of this position: ... *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which...actions to UR Committees, as appropriate * Partners with Physician Advisor to engage in second level review… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …support to Health and Medical Management clinical staff, including Care Management, Utilization Management, and the Physician Review Unit.The Operational ... tasks supporting clinical operations including the Physician Review Unit, Case Management and Utilization Management....Physician Review Unit, Case Management and Utilization Management. Some of the tasks the operational support… more