• System Director

    LifePoint Health (Brentwood, TN)
    * System Director Utilization Review * *Who we are:* At Lifepoint Health, we provide quality healthcare to rural communities. As a valued member of our ... field* **Organization:** **LifePoint Health Support Center* **Title:** * System Director of Utilization Review * **Location:** *Tennessee-Brentwood*… more
    LifePoint Health (02/04/25)
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  • Utilization Management Coordinator-…

    Houston Behavioral Healthcare Hospital (Houston, TX)
    … Management Coordinator. The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide ... Experience in a Psychiatric setting. Knowledge of healthcare service delivery systems , and third party reimbursement. Knowledgeable of Managed Care Environment.… more
    Houston Behavioral Healthcare Hospital (02/05/25)
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  • Utilization Review Nurse (RN)

    Community Health Systems (Naples, FL)
    **Job Summary** Under the direction of the Utilization Review (UR) Director /Manager the Utilization Review (UR) Nurse reviews all admissions for ... improvement programs + Addresses facility and departmental communication through daily review of all correspondence, including incoming email messages. + Performs… more
    Community Health Systems (01/31/25)
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  • Surgical Review Specialist,…

    St. Luke's University Health Network (Allentown, PA)
    …registrations and/or physician queries + Serves as liaison between Physician Advisor/Medical Director , Finance, Utilization Review Department and CDCI. ... lost with feedback to respective departments + Conduct concurrent review with utilization review department...terminology required. Previous experience with EPIC patient medical record system and 3M encoding system preferred. Please… more
    St. Luke's University Health Network (01/30/25)
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  • Program Mgr UR/Case Management - CMC - Clear Lake…

    UTMB Health (Friendswood, TX)
    … to Director and/or Assistant Director of Utilization Review /Case Management. + Maintains a documentation system of all review activities ... optimal quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical knowledge,… more
    UTMB Health (12/20/24)
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  • Director of Nursing / Nurse Manager

    BrightSpring Health Services (Dunbar, WV)
    …days of death and submit to State Health Services Director and Assigned Director , Clinical Practice* Review utilization report at least monthly to ensure ... are coordinated with behavioral and programmatic staff in partnership with the Executive Director . The Director of Nursing is accountable for overseeing the… more
    BrightSpring Health Services (12/28/24)
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  • Utilization Review Manager-Selikoff…

    Mount Sinai Health System (New York, NY)
    **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals...System is one of the largest academic medical systems in the New York metro area, with more… more
    Mount Sinai Health System (01/30/25)
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  • Market Director of Utilization

    Ascension Health (Nashville, TN)
    …+ Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully insured clients to implement ... located within TN market. We're looking for an experienced Director of Utilization Management to join our...Team** Ascension Saint Thomas is a leading health care system with a 125-year history of providing care to… more
    Ascension Health (01/24/25)
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  • Corporate Director of Clinical…

    Prime Healthcare (Ontario, CA)
    …Clinical Utilization Management (UM) provides comprehensive oversight of the Utilization Review process for the self-insured Employee Health Plans, according ... needs. + Provides strategic leadership, development, and supervision to utilization review department, provides interprofessional collaboration with… more
    Prime Healthcare (11/28/24)
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  • PRN Utilization Review Clinical…

    Community Health Systems (Franklin, TN)
    …appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for ... documentation from the physician(s). + Escalates cases to the Utilization Review Manager and/or Physician Advisor if...after the call and documented in the case management system by the UR Review Specialist. +… more
    Community Health Systems (01/08/25)
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