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...
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...
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...
, OR three (3) years of utilization/case management or third-party payer work experience. Skills & Abilities: Ability.... Experience: Three (3) years of critical care nursing experience, OR five (5) years of medical-surgical nursing experience...
, OR three (3) years of utilization/case management or third-party payer work experience. Skills and Abilities: Ability.... Experience: Three (3) years of critical care nursing experience, OR five (5) years of medical-surgical nursing experience...
for medical necessity are issued under the direction of the Medical Director or designee. Assists with transfers, when necessary... related to inpatient management per requirements. Reviews patient medical record including, but not limited, to progress...
Unlimited PTO 8 Holidays Relocation Assistance Responsibilities Include: 1.Utilization Management & Medical Necessity...Overview: Director of Utilization Review (RN) – Midland/Odessa, Texas Signet Health is seeking an experienced...
today. Today, we are seeking a Utilization Review Director in the San Diego CA area FT Role and pay is set at around $115,000 with bonus... with healthcare regulations. Key Responsibilities Leadership and Management - Directs the Utilization Review Staff and functions...
of care support. How you make a difference The Medical Director of Utilization Management leads and oversees utilization... utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners...
of care support. How you make a difference The Medical Director of Utilization Management leads and oversees utilization... utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners...
today. Today, we are seeking a Utilization Review Director in the Norman OK area FT Role and pay is set at around $105,000 with bonus... with healthcare regulations. Key Responsibilities Leadership and Management - Directs the Utilization Review Staff and functions...
today. Today, we are seeking a Utilization Review Director in the Des Moines IA area FT Role and pay is set at around $105,000 with bonus... with healthcare regulations. Key Responsibilities Leadership and Management - Directs the Utilization Review Staff and functions...
of management experience with case management and the utilization review process including concurrent reviews. Previous continuum... and treatment services. For more information, please visit us at Position Summary: Utilization Review Manager assumes...
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...
of management experience with case management and the utilization review process including concurrent reviews. Previous continuum... and treatment services. For more information, please visit us at Position Summary: Utilization Review Manager assumes...