- Penn State Health (Hershey, PA)
- …status, and family medical or genetic information._ **Union:** SEIU Healthcare Pennsylvania **Position** Utilization Management Specialist - Utilization ... responsible for maintaining compliance with the CMS Conditions of Participation for Utilization Management . MINIMUM QUALIFICATIONS: * Bachelors Degree in Nursing… 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
- Penn Medicine (Lancaster, PA)
- …each day. Are you living your life's work? Summary: + Position Summary: The Utilization Management Specialist - Denials is responsible for evaluating medical ... insurance benefit structures and related legal medical issues. + Knowledge of utilization management and quality improvement processes. + Experience working… more
- Penn State Health (Hershey, PA)
- …###@pennstatehealth.psu.edu (MAILTO://###@pennstatehealth.psu.edu) Penn State Health is seeking a dedicated ** Utilization Management Specialist ** to join our ... SEIU Healthcare Pennsylvania **Position** Specialist (Part-time) - VARIED SHIFTS - Utilization Management **Location** US:PA: Hershey | Nursing | Part Time… more
- Sanford Health (Sioux Falls, SD)
- … and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for patients in ... Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Utilization Management Specialist , Revenue Integrity and Utilization Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: ... East Tennessee to be named a Forbes "Best Employer" seven times. Position Summary: The Utilization Management Specialist I will perform utilization … more
- Sharp HealthCare (San Diego, CA)
- **Facility:** Copley Drive **City** San Diego ** Department ** **Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Driver's License ... - CA Department of Motor Vehicles; HS Diploma or Equivalent; Bachelor's...an applicant's years of experience, unique skills and abilities, education , alignment with similar internal candidates, marketplace factors, other… more
- Commonwealth Care Alliance (Boston, MA)
- …Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for ... of service decisions and organizational determinations. Essential Duties & Responsibilities: The Manager, Utilization Management reports to the Director of … more
- Henry Ford Health System (Troy, MI)
- …quality of care provided by the primary care team. He/she works with utilization management reports, corporate data stores, and information services to optimize ... waste, and rework in the region, and improve drug utilization . The Pharmacy Specialist will be instrumental...Michigan. Additional Information + Organization: Community Care Services + Department : Pharmacy- Utilization Mgmt + Shift: Day Job… 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 of ... a cancer care network, outpatient surgery centers, clinical research, medical education , a foundation, an accountable care organization, community services and more.… more