- 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
- Rochester Regional Health (Rochester, NY)
- …Per Week: Full Time/40 hours Schedule: Days (8am-4:30pm or 8:30am-5pm) SUMMARY: The Utilization Review Specialist actively participates in the utilization ... hospital with state and federal regulations, and maintain professional standards. The Senior Utilization Review Specialist assists providers with level of… 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) ... duties as required. Education: ASSOCIATE'S LVL DGRE Preferred- Two Years Utilization Review Experience Working Conditions: Manual: significant manual… 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
- 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)
- …innovative healthcare delivery system. **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding ... our patients. **This position offers the flexibility to work remotely with proven Utilization Review experience.** Medical Coding experience is a plus! As our… more