- Cleveland Clinic (Cleveland, OH)
- …career with one of the most respected healthcare organizations in the world. As a Utilization Management Specialist , you will perform UM activities, such as ... a minimum of 85% on IRR quarterly. + Complete Utilization Management for assigned patients with a...and basic disease processes + Three years of equivalent full-time clinical experience as a Registered Nurse + Analytical… 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 ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing… more
- Sanford Health (Sioux Falls, SD)
- …Sioux Falls, SD 57104, USA **Shift:** 8 Hours - Day Shifts **Job Schedule:** Full time **Weekly Hours:** 40.00 **Salary Range:** $27.50 - $38.50 **Job Summary** ... Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Quality Reporting and Auditing Specialist I Job Category: Clinical Department: Utilization Management Location: Los Angeles, ... CA, US, 90017 Position Type: Full Time Requisition ID: 12521 Salary Range:...achieve that purpose. Job Summary The Utilization Management (UM) Quality Reporting and Auditing Specialist … more
- Sharp HealthCare (San Diego, CA)
- …will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM. ... will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM.… more
- Sanford Health (SD)
- …**Location:** Remote, SD **Address:** **Shift:** 8 Hours - Day Shifts **Job Schedule:** Full time **Weekly Hours:** 40.00 **Salary Range:** $27.50 - $44 ... three years of recent clinical nursing experience required. Experience in case management , utilization management , and/or coding preferred. If working… more
- Sanford Health (Mandan, ND)
- …NW, Mandan, ND 58554, USA **Shift:** 8 Hours - Day Shifts **Job Schedule:** Full time **Weekly Hours:** 40.00 **Salary Range:** $29 - $46.50 **Department ... required. **Benefits** Sanford Health offers an attractive benefits package for qualifying full-time and part- time employees. Depending on eligibility, a variety… more
- HonorHealth (AZ)
- …you want to make an impact. HonorHealth offers a diverse benefits portfolio for our full-time and part- time team members designed to help you and your family ... here -- because it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors utilization of… more
- 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
- YesCare Corp (Brentwood, TN)
- …and proficient in utilization of those guidelines. Strong organizational and time management skills. + Experience and proficiency with ICD-10 coding, CPT ... as indicated. + Communicate and guide staff and physicians regarding utilization management program development, implementation, and evaluation and… more