- Hackensack Meridian Health (Hackensack, NJ)
- The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... population and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- Emory Healthcare/Emory University (Duluth, GA)
- …with the attending physician and/or physician advisor. + The UR Specialist will perform utilization review by completing a timely and comprehensive ... _development,_ and leadership programs + And more **Description** The Utilization Review (UR) Specialist is...ensure the continuity of patient care. + The UR Specialist serves as a resource to the Physician… more
- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …leadership, teamwork, and communication skills. ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical ... of candidates. Education Associates Degree preferred Minimum Work Experience Utilization Review experience preferably in a behavioral/psychiatric healthcare… more
- Nuvance Health (Danbury, CT)
- …any issues/denials to department leadership.* * 12) Forwards reviews that require secondary physician review to appropriate resource ( Physician Advisor) 13) ... Required- Registered Nurse ( RN) The purpose of the Utilization Management Nurse is to support the physician...as required. Education: ASSOCIATE'S LVL DGRE Preferred- Two Years Utilization Review Experience Required- Registered Nurse (… more
- HonorHealth (Scottsdale, AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Medical Center Hospital (Odessa, TX)
- Position Summary: The Utilization Review Specialist /Outcomes Specialist conducts concurrent and retrospective review functions in support of the ... hospital Utilization Review Program and makes appropriate referrals to designated Physician Advisors. Education: Holds a current Texas license as a… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Trinity Health (Stafford Springs, CT)
- …RN or Social Worker **Position Purpose** The Utilization Management Specialist is responsible for acute care concurrent review authorizations, denials ... of severity of illness (profiling) by working with the physician in the concurrent review process. May...Records) and Admitting, to provide pertinent data relating to utilization management / clinical resource management issues and questions… more
- Intermountain Health (Las Vegas, NV)
- …1-3 are a must in order to be considered for the position.** Performs medical review activities pertaining to utilization review , claims review , quality ... with MG clinicians, Affiliate Network PCPs and Specialists in the community, utilization management, care management, claims, network management, and finance. As the… more
- Catholic Health Initiatives (Omaha, NE)
- **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and optimize ... our patients. **This position offers the flexibility to work remotely with proven Utilization Review experience.** Medical Coding experience is a plus! As our… more
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