- Community Health and Counseling Services (Bangor, ME)
- Insurance Verification and Utilization Review Specialist - Health Services Job Type(s):Full-Time Location(s):Bangor, Maine Education:Associates Degree - ... staff, patients, family members, facilities and physician. Responsible for utilization management of services, verifying authorization of services throughout… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print...give will determine your eligibility and is subject to verification at any time. b. You must be at ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,161.60 - $176,872.80 Annually… more
- Baptist Memorial (Jackson, MS)
- Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed ... by utilization review standards. The UR Nurse works with providers, insurance companies and patients to ensure cost-effective and appropriate care. Areas of… more
- Ascension Health (Tulsa, OK)
- …planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance ... **Details** + **Department:** Utilization Management + **Schedule:** Full Time, Day Shift,...Tulsa, Ok **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer… more
- Ascension Health (Nashville, TN)
- …initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully insured clients to ... Provide strategic direction and oversight of the day-to-day operations of utilization management function within the insurance plan. + Ensure… more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Insurance Verification Specialist 1, under general supervision, provides patients, physicians and internal hospital personnel with ... needs. Calculates accurate patient financial responsibility. Communicates timely with Utilization Review , and collaborates effectively with physician and… more
- The County of Los Angeles (Los Angeles, CA)
- …+ Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT INFORMATION: ... the work of staff, and evaluating employee performance. For this examination, Utilization Review is defined as provides technical and administrative direction… more
- UCLA Health (Los Angeles, CA)
- …We're seeking a self-directed professional with: + Working knowledge in the insurance verification process and third party verification terminology ... completeness + Knowledge in the functional operations of third party payers and utilization review agencies to expeditiously coordinate follow-up + Knowledge of… more
- Penn Medicine (Philadelphia, PA)
- …+ Review chemo schedule in advance and determines patients insurance requirements for pre-cert, patient payments, coverage limitation and determine necessary ... insurance authorizations Internet, envoy. Follow up with all review companies on all pending authorizations and referrals. Checks-in/arrives patient appointments… more
- Mohawk Valley Health System (Utica, NY)
- …specialist regarding correct level of care and reimbursement. Apply knowledge of utilization review , discharge planning, patient status changes, length of stay, ... barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance with regulatory requirements, hospitals objectives,… more