- Montrose Memorial Hospital (Montrose, CO)
- …care provided. This position combines the unique skill sets of the Utilization Review Nurse and Clinical Documentation Specialist to facilitate documentation ... The Career: + The purpose of the Clinical Revenue Specialist position is to ensure the integrity and quality...experience preferred; and one (1) to two (2) years Utilization Review experience preferred. What We Offer: + Mentoring… more
- Datavant (Nashville, TN)
- …realize our bold vision for healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review ... of admissions for medical necessity and necessity of continued stay in the inpatient patient care setting and/or discharge to an alternative level of care. Using nationally recognized medical necessity criteria and standards of care, along with clinical… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.This is a full-time role and will be required to work onsite. ... position: *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include supervising… more
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** The Sr Specialist Integrated Care Management is a key member of the Integrated Care Management ... care teams, site and system leadership, and senior leaders, the Sr Specialist provides expert consultation on complex and escalated cases. The role also… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Under the direction of the Utilization team manager to provide administrative, operational, and organizational support for the Utilization ... referral activity. + When indicated, contact primary care physicians and specialist providers to obtain additional information required for accurate processing of… more
- UNC Health Care (Kinston, NC)
- …the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying established criteria to ... win rates. 12. Assists in documentation review in the clinical documentation specialist role when needed. Working with Clinicians and Coders to successfully… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... team partners. This position uses sound clinical judgement in the Utilization Management process and knowledge of regulatory requirements to make appropriate… more
- Trinity Health (Syracuse, NY)
- …in the discussion and notification processes that result from the clinical utilization reviews with the facilitiesPer Diem- Insurance Specialist to assist ... **Employment Type:** Full time **Shift:** Day Shift **Description:** + **Insurance Specialist - St. Josephs Health Syracuse NY** **Position Summary:** The Insurance … more
- St. Luke's University Health Network (Lehighton, PA)
- …suicidality. Job Locations: Carbon and Schuylkill counties The Veteran Certified Peer Specialist has the lived experience of service in the armed forces along ... with Veterans to facilitate their recovery and community integration through utilization of their own personal life experience and first-hand recovery knowledge.… more
- SSM Health (St. Louis, MO)
- …medical literature, rounding with other healthcare providers, drug utilization reviews, patient counseling and order entry/verification/dispensing. + Plans, ... pathways and protocols that promote appropriate medication safety and medication utilization using best practice, evidence-based recommendations. + Works in a… more