- Penn State Health (Hershey, PA)
- …medical or genetic information._ **Union:** SEIU Healthcare Pennsylvania **Position** Utilization Management Specialist - DAY SHIFT - Utilization ... for maintaining compliance with the CMS Conditions of Participation for Utilization Management . **MINIMUM QUALIFICATIONS:** + Bachelors Degree in Nursing… more
- Alameda Health System (Oakland, CA)
- System Utilization Management Specialist + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Care ... + FTE:1 + Posted:December 30, 2024 **Summary** **SUMMARY:** Supports our Utilization Management Team for all inpatient facilities enhancing operational… more
- Hackensack Meridian Health (Hackensack, NJ)
- …a. Provides direction and support regarding CMS & NJDOH regulations governing Utilization Management & Clinical documentation. b. Oversight for accurate patient ... **Overview** The Senior Utilization Review Specialist collaborates with the...vs. Inpatient c. Liaison to the Medical Staff supporting Utilization Management Committee processes d. Hospital Based… more
- Vanderbilt University Medical Center (Nashville, TN)
- …through preeminent programs in patient care, education, and research. **Organization:** Utilization Management 20 **Job Summary:** JOB SUMMARY Facilitates ... a community of individuals who come to work each day with the simple aim of changing the world....admission status is ordered. Conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary… more
- Munson Healthcare (Traverse City, MI)
- …of resources. + Assists in developing and revising policies to support utilization management activities, including criteria and guidelines for appropriate use ... colleagues and hospital associates at information meetings. + May represent Utilization Management on various committees, professional organizations, physician… more
- Trinity Health (Maywood, IL)
- …in collaboration with attending physicians. + Actively participates in the Utilization Management committee. + Additional responsibilities as needed. **We ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Utilization Review- RN...Position is hybrid, must reside in Illinois. The **Regional Utilization Review Documentation Specialist ** nurse works with… more
- MetroHealth (Cleveland, OH)
- …**Responsible for communicating information to internal and external customers of the Utilization Review and Care Management Department. Follows up on inquiries ... from payors and provides the appropriate information to Utilization Review, providers, payors, and admitting. Upholds the mission,...sit, stand, stoop, bend, and ambulate intermittently during the day . May need to sit or stand for extended… more
- Ascension Health (Baltimore, MD)
- **Details** + **Department:** Utilization Management + **Schedule:** On-site, Monday-Friday, 8:00AM-4:30PM. Must be available as needed to address urgent or ... assists with the budgeting process. + Serve as content specialist for staff in the areas of utilization...related experience is required. **Additional Preferences** + **5 years Utilization Management experience, 2 years management… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... Resource Management issues, other issues including concerns involving under/over utilization , avoidable days and quality issues. 13. Responsible for all incoming… more
- Henry Ford Health System (Bingham Farms, MI)
- …quality of care provided by the primary care team. He/she works with utilization management reports, corporate data stores, and information services to optimize ... of pharmacy services, decrease waste, and rework in the region, and improve drug utilization . The Pharmacy Specialist will be instrumental in guiding the further… more