- Florida Health Care Plans, Inc. (Daytona Beach, FL)
- … Office Specialist provides clerical support to clinicians performing utilization review and case management for members hospitalized or receiving ... information, communicating electronically and telephonically, interpreting data, and time management to meet department timeframes. Individuals must have strong… more
- Community Health Systems (Franklin, TN)
- …Documents all utilization review activities in the hospital's case management software, including clinical reviews, escalations, avoidable days, payer ... + Bachelor's Degree in Nursing preferred + 2-4 years of clinical experience in utilization review , case management , or acute care nursing required + 1-3… more
- BriteLife Recovery (Englewood, NJ)
- …as assigned What we need from you? + Minimum of 2-3 years of experience in utilization review , case management , or insurance coordination in a behavioral ... What you will be doing? The Utilization Review (UR) Specialist is a...Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review / case management /clinical/or combination; ... Friday, 8:30am-5:00pm. **Job Description:** + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …Management , or related field * Minimum 3 years of experience in clinical care, utilization review , case management , or clinical denials/appeals -OR- * ... *_SUMMARY:_* We are currently seeking a Utilization Management Analyst to join our...coordinating peer-to-peer reviews, and working closely with physician advisors, case management , and revenue cycle teams. The… more
- Elevance Health (Winston Salem, NC)
- …Carolina. Alternate locations may be considered. The **Medical Director** will be responsible for utilization review case management for North Carolina ... ** Utilization Management Medical Director- NC Medicaid**...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- UTMB Health (Friendswood, TX)
- …and a safe and efficient work environment. + Monitors the work performance of the Utilization Review Case Management staff and provides guidance as ... area and/or general nursing. + Provides assistance with clinical issues for non-nursing Utilization Review Case Management staff. + Contributes to the… more
- Wellpath (Lemoyne, PA)
- …role** The Medical Director of Utilization Management leads and oversees utilization review , case management , quality improvement, and related ... appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and stakeholders,… more
- Henry Ford Health System (Detroit, MI)
- …skills. + Proficiency with computers, electronic health records (EHR), database systems, and utilization review / case management documentation systems. + ... sign on bonus available for qualified experienced candidates with current 2 years RN Case Management in a large acute care hospital setting. GENERAL SUMMARY: The… more
- Henry Ford Health System (Detroit, MI)
- … skills. Knowledge of computers, Electronic Health Records, data base systems and utilization review / case management documentation systems. Desire to ... on bonus available for qualified experienced candidates with current 2 years MSW Case Management in a large acute care hospital setting. GENERAL SUMMARY: The … more