- Prisma Health (Greenville, SC)
- …designing systems to meet department and organizational strategic initiatives. Coordinates with utilization review to determine need for authorization of payer ... accordance withapplicable standards and regulations. Monitors caseload and quality review to assure compliance for third-party payers and regulatory… more
- CareSource (Las Vegas, NV)
- …appeals, Medicare, and Medicaid experience preferred Prior clinical appeals, and/or Utilization review experience is strongly preferred Competencies, Knowledge ... to resolve complex cases. Communicate outcomes effectively to members, and providers. Review and complete all provider clinical appeals within required timeframes … more
- Johns Hopkins University (Baltimore, MD)
- …by the department and school participate in annual performance improvement goals. Review monthly account and/or business plan activity, correct errors, and identify ... reports, as needed, for JHM, JHHS, JHU and departmental leadership. Provide, review , and analyze the clinical practice finances of assigned area. Develop appropriate… more
- Johns Hopkins University (Baltimore, MD)
- …monthly administrative staff meetings Resolve scheduling conflicts, monitor room utilization , and maintain clinic patient flow. Coordinate the hiring, training, ... for budgets and prepare documents required to maintain balanced accounts for review and approval by the Assistant Administrator. Assist in the development of… more
- Universal Health Services, Inc. (Las Vegas, NV)
- …and retrospective review of inpatient medical records to evaluate the utilization and documentation of acute care services. The goal of concurrent review ... includes facilitation of appropriate physician documentation of care delivered to accurately reflect patient severity of illness and risk of mortality. Specific reviews are determined both internally and by requirements/requests of external payers or… more
- Universal Health Services, Inc. (Arlington, TX)
- …contact with the community and interfaces closely with the Program Director, utilization review staff, Millwood Hospital staff and the Community Education ... part of a large network of peer co-workers that routinely exchange ideas and review current topics within the industry. Having the opportunity to grow, learn, and… more
- Universal Health Services, Inc. (Ocala, FL)
- …work with all facility units: business office, medical staff, medical records, utilization review , marketing, and nursing. The Vines' Admissions department is ... staff and documenting all necessary information in Med Series 4. The RN will review packets, accept and admit patients. This position requires a person to work with… more
- Universal Health Services, Inc. (Phoenix, AZ)
- …The Case Manager is knowledgeable about and responsible for treatment plans, utilization review , discharge planning, psychoeducation groups, and case management. ... case managers, therapists, and clinical leaders that routinely exchange ideas and review current topics within the industry. Having the opportunity to grow, learn,… more
- Johns Hopkins University (Baltimore, MD)
- …support in response to emergency situations. Prepare chart documentation for review and counter signature by the physician. Determine differential diagnosis. ... to obtain informed consent from study participants. Remain proficient in the utilization of commonly used clinical protocols and guidelines. Remain abreast of new… more
- Universal Health Services, Inc. (Ocala, FL)
- …will work with all facility units: business office, medical staff, medical records, utilization review , marketing, and nursing. This position also qualifies for ... staff and documenting all necessary information in Med Series 4. The RN will review packets, accept and admit patients. This position requires a person to work with… more
