Job Description: Coordinates utilization review activities to ensure clinical documentation is accurate to secure.... Collaborates and partners closely with the Manager of Business Operations and their team to secure authorizations for treatment...
Job Description: Coordinates utilization review activities to ensure clinical documentation is accurate to secure.... Collaborates and partners closely with the Manager of Business Operations and their team to secure authorizations for treatment...
, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal processes. Provides staff education..., reporting them promptly to the Process Improvement/Quality Director, to appropriate clinicians and to the UM Manager. Reviews...
date or job transfer date required. BLS Provider preferred. American Heart Association or American Red Cross accepted. Case Manager... credentialed from the Commission for Case Manager Certification (CCMC) preferred. Education: Diploma from an accredited school...
with internal and external customers and the Pharmacy Benefit Manager (PBM) to resolve issues that may arise in the provision... Pharmacy Benefit Manager (PBM) to resolve issues that may arise in the provision of pharmacy services. Processes determination...
Medicaid services (e.g. Psychosocial Rehabilitation, Targeted Case Management, Home Based Habilitation, Supported Employment..., and local guideline requirements; and perform of other duties as required by the reviewer's manager Review of outpatient...
Medicaid services (e.g. Psychosocial Rehabilitation, Targeted Case Management, Home Based Habilitation, Supported Employment..., and local guideline requirements; and perform of other duties as required by the reviewer's manager Review of outpatient...
. ORGANIZATION This position reports to the System Manager of Revenue Integrity, and will be responsible for working denials... with Management, Physicians, and Clinical leaders throughout the system. AGE OF PATIENTS SERVED Cares for patients in the age...
Post Service Clinical Review nurse will report to the manager of FEP Post Services. In this role you will be reviewing... and intervenes or as clinically appropriate Provides referrals to Case Management, Disease Management, Appeals and Grievance...
coverage determinations. Management policies; meeting health plan inter-rater reliability guidelines. Schedule... and manager for all clinically related activities. Assures that organization medical policies and procedures adhere...
reviews, denial prevention and appeal management. The Utilization Manager will provide developmental training to clinical...Job Summary: The Utilization Manager leads a team that is responsible for all authorization processes. Oversee timely...
Job Title: Registered Nurse – Case Manager / Utilization Review / CDI Location: Syracuse, NY Type: Contract Shift... management and utilization review for patients in acute care settings. Ensure appropriate care coordination and discharge...
Job Title: Registered Nurse – Case Manager / Utilization Review / CDI Location: Syracuse, NY Type: Contract Shift... management and utilization review for patients in acute care settings. Ensure appropriate care coordination and discharge...
Job Title: Registered Nurse – Case Manager / Utilization Review / CDI Location: Syracuse, NY Type: Contract Shift... management and utilization review for patients in acute care settings. Ensure appropriate care coordination and discharge...
Job Title: Registered Nurse – Case Manager / Utilization Review / CDI Location: Syracuse, NY Type: Contract Shift... management and utilization review for patients in acute care settings. Ensure appropriate care coordination and discharge...
Job Title: Registered Nurse – Case Manager / Utilization Review / CDI Location: Syracuse, NY Type: Contract Shift... management and utilization review for patients in acute care settings. Ensure appropriate care coordination and discharge...
Job Title: Travel RN – Case Manager / Utilization Review / CDI Location: Syracuse, NY 13210 Duration: 13 Weeks Shift...) specializing in Case Management, Utilization Review, and Clinical Documentation Improvement (CDI) for an acute care hospital...
Job Title: Travel RN – Case Manager / Utilization Review / CDI Location: Syracuse, NY 13210 Duration: 13 Weeks Shift...) specializing in Case Management, Utilization Review, and Clinical Documentation Improvement (CDI) for an acute care hospital...
Job Title: Travel RN – Case Manager / Utilization Review / CDI Location: Syracuse, NY 13210 Duration: 13 Weeks Shift...) specializing in Case Management, Utilization Review, and Clinical Documentation Improvement (CDI) for an acute care hospital...
Job Title: Travel RN – Case Manager / Utilization Review / CDI Location: Syracuse, NY 13210 Duration: 13 Weeks Shift...) specializing in Case Management, Utilization Review, and Clinical Documentation Improvement (CDI) for an acute care hospital...