- Tenet Healthcare (Detroit, MI)
- Group Director Utilization Review - 2506000536 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves ... employers in Southeast Michigan. Summary Description SUMMARY: The Group Director , Utilization Review will perform...preferred, Six Sigma Green Belt preferred · Valid Registered Nurse (RN) preferred PHYSICAL DEMANDS: -Lift/position up to 25… more
- Elevance Health (Woodbridge, VA)
- RN Utilization Review Nurse (Washington DC Medicaid) JR149756 **Location** : This role requires associates to be in-office 4 days per week, Monday - ... located at 609 H. Street NE. The **Medical Management Nurse ** is responsible for review of the...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or… 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** + ... Current license to practice as a Registered Nurse in the State of Utah, or obtain one...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
- Ascension Health (Baltimore, MD)
- …salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes ... functions for assigned sites. + Collaborate with the director to develop and implement quality review ...review programs and key performance indicators for all utilization review activities. + Interact with medical,… more
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... in both areas.* Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures...Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal… more
- AmeriHealth Caritas (Dover, DE)
- …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... + Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work Monday through Friday,… more
- Dignity Health (Gilbert, AZ)
- …the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on… more
- UPMC (Hanover, PA)
- **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a rotating ... the clinical and financial plan for patients. Performs overall utilization management, resource management, discharge planning and post-acute care referrals… more
- Trinity Health (Des Moines, IA)
- …**Description:** **_Are you an experienced Director of Care Management & Utilization Review looking for an interim assignment? Join Trinity Health 's ... and organizational goals. **MINIMUM QUALIFICATIONS:** + Current Iowa License Registered Nurse or Social Worker + Master's degree in healthcare related field… more
- Alameda Health System (Oakland, CA)
- …each individual in the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. + ... Director , Utilization Management + Oakland, CA...reviews and determine program improvements. + Develop and implement utilization review policies and procedures in accordance… more
Related Job Searches:
Director,
Director Utilization,
Director Utilization Review,
Nurse,
Nurse Director,
Review,
Review Nurse,
Utilization,
Utilization Review,
Utilization Review Nurse