Weekly Hours: 40 Department: Utilization Management Overview of Position: Acts as part of a multidisciplinary team..., and assesses quality, identifying and reporting potential risk management issues. Utilization Management analyzes and trends...
The purpose of the Utilization Management Nurse is to ensure quality of patient care, effective utilization... in turnaround time requirements as mandated by the TAT Standards Responsible for working closely with supervisor/lead to address...
Role Overview: Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity... based on clinical criteria. Using professional judgment, the Utilization Management Reviewer assesses the appropriateness...
approved services are provided. Our Utilization Management Reviewers cultivate and maintain relationships with our members... setting. Utilization Management experience, preferably within a managed care organization, desired. Experience utilizing...
Utilization Management staff. Oversee staff performance with regard to medical necessity determinations, concurrent review... of LTSS Review Utilization Management audits, such as readiness review and site visits, pertaining to the LTSS Review...
” encounters with providers and appropriate others to facilitate and coordinate the Utilization Management process(es) activities... management and specialty pharmacy services, behavioral health services, and other administrative services. Discover...
Imagine360 is seeking a Utilization Management, RN to join the team! The RN Utilization Management Nurse is responsible... as needed with members, physicians, other healthcare professionals, peers, Supervisor of UM to complete the utilization process per Care 360...
as assigned. Supervisory/Management Responsibility This is a non-management job that will report to a supervisor, manager... (2) years acute care nursing experience. One (1) year acute case management or utilization management experience...
of Utilization Review (UR) and Case Management!*** The UR and Case Management Director assists admissions in screening patients... years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia preferred. Current...
Management Nurse to join our team! As a Utilization Management Nurse on the team, you will be responsible for reviewing patient... in either Case Management or Utilization Management. Responsibilities Review patient files and treatment information...
. Discover more about us at www.amerihealthcaritas.com. Responsibilities: The Utilization Management Tech functions under the... experience preferred Work experience in utilization management/review in a healthcare/MCO setting preferred Knowledge...
. Discover more about us at www.amerihealthcaritas.com. Responsibilities: The Utilization Management Tech functions under the... experience preferred Work experience in utilization management/review in a healthcare/MCO setting preferred Knowledge...
dialog with supervisor and other health providers to ensure effective implementation of health plan. Act as a resource... experience in Case Management required. Local and national travel options are available depending on need. Candidates...
We are recruiting for a motivated Supervisor, Nursing Utilization Review to join our team! We are here for life.... Department Hospital Care Mgmt Job Summary The Supervisor, Nursing Utilization Review is responsible for the clinical...
. Discover more about us at www.amerihealthcaritas.com. Responsibilities: The Utilization Management Tech functions under the... experience preferred Work experience in utilization management/review in a healthcare/MCO setting preferred Knowledge...
Under the direction of the Case Management Coordinator, coordinates, negotiates, procures and manages the care... improvement initiatives related to the management of patient care. Works with physicians to ensure accurate and thorough...
Job Description: Responsibilities Utilization Review Specialist Rivendell Behavioral Health Services is an 80-bed.... Rivendell Behavioral Health Services of Arkansas is seeking a Utilization Review Specialist for full time status. The...
JOB DESCRIPTION SUMMARY Reports to the Nurse Supervisor and assists in the process of health management and utilization review (UR). The...Johnson Service Group (JSG) is seeking a Bilingual Utilization Review Coordinator. This position is remote - MUST WORK...
Supervisor of Behavioral Health Utilization Management to identify and solve problems related to providers, provider networks..., etc.) regarding authorizations, utilization management and coordination of inpatient acute care, sub-acute, outpatient care...
and Appeals Coordinator will perform activities to help facilitate utilization management and appeals functions to include... for utilization management and appeals processes, performs data management and coordinates communication between members of the...