- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …UR Specialist to provide Per Diem coverage. Job Description: The Utilization Review Specialist is responsible for monitoring adherence to the ... hospital's utilization review plan to ensure the effective...experience. + 2-3 years experience working as a UR Specialist , Medical Billing or health care quality assurance. +… more
- HonorHealth (AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors utilization ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Utilization Review Specialist (RN) Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 Hours ... (Full-Time) Schedule: Monday - Friday, Days SUMMARY:The Utilization Review Specialist actively participates in the utilization management of patients and… more
- Trinity Health (Maywood, IL)
- …is Loyola campus. Position is hybrid, must reside in Illinois. The **Regional Utilization Review Documentation Specialist ** nurse works with the ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Utilization Review - RN Reviewer- Regional Coverage for Loyola, Gottlieb and MacNeal… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A....Requests / Denials when received in the department as per protocol + Requests or provides Medical Records as… 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 stay.… more
- Stony Brook University (Stony Brook, NY)
- Per Diem - Behavioral Health Specialist **Position Summary** At Stony Brook Medicine, our Behavioral Health Specialist : + Orients patients to treatment ... interventions, restraint/seclusion, behavior plan development and safety plan development, utilization and monitoring. + Conducts a variety of patient treatment… more
- Nuvance Health (Danbury, CT)
- …the time of review . If unable to resolve, escalate to the PA and Utilization Review (UR) Leadership. * Coordinate with the care team in changing patient ... *Description* * Per Diem Shifts Available- Days, Evenings, Nights available*...to internal leadership for assistance in resolution. *Responsibilities* * Review all inpatient admission and observation cases using InterQual,… more
- Houston Methodist (Sugar Land, TX)
- …Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management and ... Seven years clinical nursing/patient care experience which includes three years in utilization review , case management or equivalent revenue cycle clinical role… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and tracks ... experimental, coding or other issues that may require record review . Provides billing with information needed to obtain payment...SENSORY REQUIREMENTS: Requires sitting for up to 4 hours per day, 2 hours at a time. Standing for… more