The Senior Medical Director (Senior MD) serves as the clinical and strategic leader for Integra’s Utilization... as operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director(s), ensures...
Clinician responsible for utilization management services within the scope of licensure. Conducts primary functions of prior... years of acute care clinical experience. Previous Utilization Review and Case Management experience a plus. Commercial...
each and every day. Job Description: The Utilization Review RN performs activities which support the Utilization Management... functions. They are responsible for the delivery of the Utilization Management process including but not limited to: making...
, preferably in Case Management and/or Utilization Management. Specialized Training: Trained in Epic, InterQual, Midas..., and resource/utilization management. The position requires excellent communication, clinical skills, and professional rapport...
Job Category: Revenue Cycle Management Degree Level: High School Diploma/GED Job Description: Utilization Review... care to others. As a Utilization Review Clerk joining our team, you're embracing a vital mission dedicated to making...
and operational leadership to the day to day function of the Utilization Management Team. The UM Nurse Manager will ensure that the... UM Medical Director and/or the Director of Medical Management. Ensure network provider steerage and happening on OON network...
as an RN, preferably in a hospital setting 2+ years Utilization Management experience in a health plan UM department... as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse is responsible for ensuring the receipt...
under the supervision of the Manager/Director and is responsible for working in collaboration with the healthcare team... to coordinate the care and service to patients across the continuum of care. The care manager promotes effective utilization...
requirements within the utilization management process. 10. Maintains proficiency in the application of organization selected... utilization reviews, physician advisor referrals and other communications related to assigned cases in accordance with department...
team, Director of Utilization Management, and the Medical Director. Review charts at identified review points and attend... as a leader of positive change. The Utilization Management Coordinator utilizes clinical knowledge and understanding...
management and/or utilization review experience Associate degree required; bachelor's Degree preferred. Strong problem-solving... Utilization Manager is responsible for the day-to-day functions of collaborative communication with external case managers...
Director to monitor utilization patterns in line with quality indicators to optimize referral authorizations. Works... to all. Services include, but are not limited to adult care, chronic disease management, pediatrics, comprehensive women’s care...
Job Category: Revenue Cycle Management Degree Level: Bachelor's Degree Job Description: Position Summary The... Utilization Review Specialist is responsible for managing and coordinating the utilization review process for inpatient...
each and every day. Job Description: The Utilization Review RN performs activities which support the Utilization Management... functions. They are responsible for the delivery of the Utilization Management process including but not limited to: making...
patient needs from admission through discharge. Under the general supervision of the Director of Case Management, develops... job duties. Accountability: Reports to: Director of Case Management Supervises: None Qualifications: Current Licensure...
patient needs from admission through discharge. Under the general supervision of the Director of Case Management, develops... job duties. Accountability: Reports to: Director of Case Management Supervises: None Qualifications: Current Licensure...
principles of utilization management and serves as a consultant for issues regarding regulations, compliance, payor specific... criteria and the denial management process for the DCH System. Responsibilities: * Supervises utilization review professional...
Kingdom. www.uhs.com The UM Supervisor oversees the utilization management of the Behavioral Health Center including... UM goals and collaboration with the CBO as needed. This position oversees the Utilization Management Coordinator. The...
Kingdom. www.uhs.com The UM Supervisor oversees the utilization management of the Behavioral Health Center including... UM goals and collaboration with the CBO as needed. This position oversees the Utilization Management Coordinator. The...
: $71,612.39 - $110,999.20 Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. Completes Utilization... service. Recent experience in case management, utilization management and/or discharge planning/home care in a high volume...