- Sharp HealthCare (San Diego, CA)
- …roundsReviews every patient under assigned workload initially and reviews based on review of care plan.Makes rounds and sees every patient identified per ... departmental guidelines during hospital stay beginning with the admission review of the case manager and reviews with the...quality of care issues encountered in the course of review .Serves as a resource for staff (as needed), and… more
- Ventura County (Ventura, CA)
- …+ Experience with managed care + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review systems and programs + At ... + Experience with managed care + Experience and current knowledge of Quality Assurance, Utilization Review and Peer Review systems and programs + Direct… more
- Evolent (Helena, MT)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to… more
- Hartford HealthCare (Mansfield Center, CT)
- …patient care decisions to support optimal clinical and operational outcomes. They review visit utilization for care appropriateness and collaborate with ... ensure quality and reliability. Guides staff on clinical, documentation, and utilization decisions to improve OASIS accuracy and care quality, recommending… more
- Evolent (Helena, MT)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... culture. **What You'll Be Doing:** As a Physician Clinical Reviewer , Interventional Pain Management, you will be a key...Management, you will be a key member of the utilization management team. We can offer you a meaningful… more
- Northwell Health (Bay Shore, NY)
- …action. + * Acts as a liaison with patients insurance carrier (case manager, utilization reviewer ) to coordinate post hospital services and referrals. + * Makes ... to the Hospital. Job Responsibility + * Performs concurrent review on all patients and share all problematic cases...as required. + * Participates in the maintenance of Utilization Management, Discharge Planning and Case Management statistics as… more
- Evolent (Helena, MT)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Director you will be a key member of the utilization management team. We can offer you a meaningful...Will Be Doing:** + Serve as the specialty match reviewer in Cardiology cases, that do not initially meet… more
- Evolent (Sacramento, CA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Director you will be a key member of the utilization management team. We can offer you a meaningful...Will Be Doing:** + Serve as the specialty match reviewer in Vascular cases, that do not initially meet… more
- CVS Health (Baton Rouge, LA)
- …members across Aetna. **Expectations and Responsibilities:** * Serve as the principal utilization management reviewer for cases related to Applied Behavior ... consumer-focused, and acknowledges physicians for their clinical excellence and effective utilization of health care resources. Reporting to the Executive Behavioral… more
- Evolent (Helena, MT)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Oncology, you will be a key member of the utilization management team. We can offer you a meaningful...Will Be Doing:** . Serve as the Physician match reviewer in Advanced Imaging cases, that do not initially… more