- ERP International (Camp Pendleton, CA)
- …patient safety by monitoring and tracking the enrolled population for hospital admissions and emergent/urgent utilization , making contact with the patient, ... manuals, reports and actively engages patients in their health care. + Review details and expectations regarding referrals with patients. + Provide support to… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services ... to ensure compliance with utilization management policies. This role conducts admission ...healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence… more
- Spectrum Billing Solutions (Skokie, IL)
- …Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management ... a remote or office/home hybrid position. Your Responsibilities: + Review patient admission and clinical information to... | UR Specialist | Revenue Cycle Utilization Review Specialist | ABA… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is ... responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients...and advocating for appropriate levels of care. The UR Specialist works closely with clinical staff, admissions ,… more
- Community Health Systems (Franklin, TN)
- …timely authorizations for hospital admissions and extended stays. The Utilization Review Coordinator monitors and documents all authorization activities, ... authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist . +...Degree preferred + 0-2 years of work experience in utilization review , hospital admissions or… 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: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,... in any inpatient setting. Performs telephonic and/or onsite admission and concurrent review , and collaborates with… more
- St. Peters Health (Helena, MT)
- …members are out of the office. 2. Complete comprehensive review of all admissions to SPH. These are evaluated for admission status. 3. Follow-up daily on ... The Utilization Management RN reports directly to Utilization Review RN Coordinator. The UR RN...orders when appropriate; continued stay reviews for cases where admission exceeds the GMLOS, documentation of avoidable, initiation of… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing… 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 ... this position: *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include… more
- HCA Healthcare (Largo, FL)
- …and personal growth, we encourage you to apply for our Clinical Rehab Specialist PRN opening. We review all applications. Qualified candidates will be ... have the PRN career opportunities as a(an) Clinical Rehab Specialist PRN you want with your current employer? We...to ensure a responsive and smooth flowing referral and admission process for the inpatient acute rehab program. +… more
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