- 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
- Hartford HealthCare (Hartford, CT)
- …The primary responsibility of the Metabolic and Bariatric Surgical/Medical Clinical Reviewer (MBSCR) is to ensure the accurate and timely collection, documentation, ... with bariatric surgeons, general surgery teams, the Metabolic and Bariatric Program Coordinator , Medical Weight Loss team, and the Quality Department to identify… 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
- St. Luke's University Health Network (Allentown, PA)
- … utilization management of psychiatric cases in the absence of the utilization management coordinator . PHYSICAL AND SENSORY REQUIREMENTS: Able to communicate ... appropriate to the age of the patient treated. + Performs admission review on all inpatients. Attends daily patient rounds and shares professional knowledge,… more
- State of Michigan (Lansing, MI)
- …regimens that require additional physician review according to policy, the Utilization Reviewer actively monitors Medicaid claims data. Cases identified are ... individuals with psychotropic medication regimens that require additional physician review , preparing the physician review materials, and...prepared and assigned by the Utilization Reviewer to the MDHHS psychiatrist performing… 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
- 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 ... of Connecticut's most comprehensive healthcare network years an Oasis Workflow Coordinator Hartford HealthCare at Home, the largest provider of homecare services… more
- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the CMHS. ... and the TRICARE Operations Manual (TOM) access to care standards for appropriate utilization of services. Perform utilization management/ review for medical… more