- Luke Staffing (Yigo, GU)
- …of clinical nursing experience is required. One year of previous experience in Utilization Management is required. Full time employment in a nursing field ... requirements of this position, it must be directly related to referral/ utilization management . + **Licensure:** Current, full, active, and unrestricted… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for receiving/reviewing… more
- Cedars-Sinai (Los Angeles, CA)
- …Assists with investigation and follow-up regarding customer complaints. + Serves as liaison with other units in the Admissions department. **Qualifications** ... of service cash collections and cash flow, and provide efficient and appropriate utilization of resources. Acts as a resource for team members by assisting with… more
- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500016 Admissions Center-SMH Work Shift: UR - Rotating (United States of America) Range: ... **Responsibilities:** GENERAL SUMMARY Coordinates or manages inpatient and outpatient admissions , including bed assignments and the completion of preliminary… more
- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500016 Admissions Center-SMH Work Shift: UR - Rotating (United States of America) Range: ... financial eligibility, secures account for billing and coordinates account management through discharge Completes appropriate forms to complete Death Certificate… more
- Calvary Hospital (Bronx, NY)
- …pertinent data. 8. Knowledge of and experience in Quality Assessment and Improvement, Utilization Review. 9. Ability to develop management systems to track data ... Outreach, Admitting and Intake implementing changes when appropriate. Acts as liaison between Calvary Hospital and referring institutions and providers. Actively… more
- UTMB Health (Webster, TX)
- …efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions, ... UTMB TDCJ Hospital to specialty services hospitals. **_ESSENTIAL JOB FUNCTIONS_** **:** Utilization Management + Demonstrates thorough knowledge of Inter Qual… more
- St. Peters Health (Helena, MT)
- …and supportive liaison and educator to providers and staff around utilization management principles. This professional role will be responsible for: 1. ... The Utilization Management RN reports directly to...Facilitation of peer to peer calls for both hospital admissions and for specific outpatient service denials as assigned,… more
- Community Health Systems (Franklin, TN)
- …preferred **Knowledge, Skills and Abilities** + Strong knowledge of utilization management principles, payer requirements, and healthcare regulations. ... Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and appeals… more
- CaroMont Health (Gastonia, NC)
- …to MCO via fax, Provider Link, or telephonically. Gathers and disseminates Utilization Management information to medical staff departments, Nursing departments, ... to practice in NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management , Quality and/or Case Management preferred.… more
