within the Utilization Management (UM) department, including staffing, assignment management, and serving as the first line... of Utilization Management, typically gained through a bachelor’s degree in Nursing, Healthcare Administration, or a related field...
, RN is responsible for providing clinically efficient and effective Inpatient utilization management. Reviews inpatient... guidelines for medical appropriateness of procedure, service or treatment for review with the Medical Director for a decision...
determines are necessary or desirable to meet its business needs Assist and support the Director and Utilization Management... and the Bassett Healthcare Network Collaborate with peers in Medical Management, Case Management, RCM, Compliance...
Overview: NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate... for Utilization Management Registered Nurse: Develop, implement, and administer the quality assurance and utilization review...
, RN is responsible for providing clinically efficient and effective Inpatient utilization management. Reviews inpatient... guidelines for medical appropriateness of procedure, service or treatment for review with the Medical Director for a decision...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office... for Utilization Management Registered Nurse: Develop, implement, and administer the quality assurance and utilization review...
, experience and growth. The Product Manager - Utilization Management and Prior Authorization will report to the Senior Director... products Requires expertise and thought leadership in Utilization Management and Prior Authorization solutions Experience...
but saving them. Together. The Senior Manager, Inpatient Utilization Management (California LVN / RN Required) under the... direction of the Director of UM, is responsible for ongoing management of the UM Department, oversees clinical staff, ensuring...
as needed with the utilization management physician advisors and/or medical directors on problematic cases and documents his decisions...Job Category: Revenue_Cycle Job Description: Under broad direction from the Centralized Utilization Management...
, utilization and case management, or medical staff governance required. Preferred: Experience as a Physician Advisor... necessary approvals of new strategies for utilization management. Knowledge of current medical literature, research methodology...
to policies and procedures. Communicates utilization plans to case management team. Evaluates concurrent and retrospective denials... in acute care setting required 2 years Case Management or Utilization Management experience preferred 1-2 years leadership...
to the Director of Utilization Review and will be responsible to provide quality case management services to all patients...) currently has an opening for Part-time Utilization Management Coordinator. The Utilization Management Coordinator will report...
precertification requests for medical necessity, referring to the Medical Director those that require additional expertise. Review... of two (2) years of prior experience in Utilization Management. Must possess a current, active, full, and unrestricted...
Medicare criteria. Responsibilities: Reviews and evaluates medical or behavioral eligibility regarding benefits... requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis...
requests by Providers. Acts as a department resource for medical service requests /referral management and processes. Receives... Required: At least 5 years of varied RN clinical experience in an acute hospital setting. At least 2 years of Utilization Management/Case...
We are recruiting for a Utilization Management Coordinator (UMC) to join an established healthcare organization... of Medical Management. Answer telephone; screen and direct calls to appropriate staff member or department. Effectively works...
precertification requests for medical necessity, referring to the Medical Director those that require additional expertise. Review... of two (2) years of prior experience in Utilization Management. Must possess a current, active, full, and unrestricted...
outcomes, and promote health equity. Position Responsibilities: Specific Design utilization management programs... and outpatient utilization management programs to ensure cost-effective use of patient care resources case delivery at the...
-service operations under the direction of the Director of Utilization Management. This role provides leadership... but saving them. Together. The Manager, Utilization Management (UM) Coordination, oversees non-clinical inpatient and pre...
The UM Coordinator assists and supports the clinical team (UM Nurses/Medical Director) with administrative and non...-clinical tasks related to processing Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES Monitor...