- 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
- Vanderbilt University Medical Center (Tullahoma, TN)
- …is to advance health and wellness through preeminent programs in patient care, education , and research. **Organization:** Utilization Management 10 **Job ... + Facilitates throughput of patients admitted urgently or emergently through the emergency department . + Participates as an active partner with multidisciplinary… 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
- Covenant Health Inc. (Harriman, TN)
- Overview Emergency Department Patient Registration Specialist , Admitting & Registration PRN/OCC, Hours and Shifts Vary Roane Medical Center Overview: Proudly ... and satisfaction at Roane Medical Center. Position Summary: The Emergency Department Patient Registration Specialist ... for the Advanced Care at Home program and Utilization Management . + Rotates on-call and holiday… more
- AdventHealth (Hendersonville, NC)
- …and collects payments or establishes payment plans. + Coordinates with utilization management staff for pre-authorization issues and ensures patients ... have necessary logistical information. + Contacts insurance companies to verify eligibility and benefits, and obtains pre-authorizations within established timeframes. + Registers patients for all services, ensuring accuracy and minimizing duplication of… more
- LA Care Health Plan (Los Angeles, CA)
- …staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time lines by maintaining ... Authorization Technician II Job Category: Clinical Department : Utilization Management Location:...purpose. Job Summary The Authorization Technician II supports the Utilization Management (UM) Specialist by… more
- Trinity Health (Maywood, IL)
- …in collaboration with attending physicians. + Actively participates in the Utilization Management committee. + Additional responsibilities as needed. **We ... Loyola campus. Position is hybrid, must reside in Illinois. The **Regional Utilization Review Documentation Specialist ** nurse works with the multidisciplinary… more
- Roper St. Francis (Summerville, SC)
- …(KPIs) and other outcome metrics relevant to unit/patient population. Assists Clinical Specialist with updating unit visual management boards each shift. ... its first patients in 2026. This expansion will bring enhanced access to emergency care, imaging, lab services, outpatient surgery and women's health, right in the… more
- Roper St. Francis (Summerville, SC)
- …(KPIs) and other outcome metrics relevant to unit/patient population. Assists Clinical Specialist with updating unit visual management boards each shift. ... its first patients in 2026. This expansion will bring enhanced access to emergency care, imaging, lab services, outpatient surgery and women's health, right in the… more
- Houston Methodist (Houston, TX)
- …the leadership team for special project activities related but not limited to, throughput, utilization review and utilization management to align with the ... At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position...members. + Serves as the primary information resource for utilization management staff, payers, physicians, and other… more
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