• Utilization Review / Quality

    SUNY Upstate Medical University (Syracuse, NY)
    Job Summary: The Utilization Review / Quality Assurance Coordinator is responsible for all compliance related paperwork and ensures all compliance ... paperwork is completed in a timely manor for the Upstate/Syracuse City School District school-based mental health care program. This position helps ensure successful visits by DNV and OMH when they occur. Monitors and maintains performance improvement… more
    SUNY Upstate Medical University (03/04/25)
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  • Quality Assurance Senior…

    SUNY Upstate Medical University (Syracuse, NY)
    Job Summary: The Utilization Review / Quality Assurance Sr. Coordinator will be responsible for providing clinical information to managed care companies as ... regulatory agencies, and other health care related entities. Preferred Qualifications: Utilization Review /Managed Care/ Quality Assurance experience.… more
    SUNY Upstate Medical University (03/10/25)
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  • Asst Utilization Coordinator - Appeals

    WMCHealth (Valhalla, NY)
    …hospital or health care agency, one of which must have been in the area of utilization review , quality assurance , risk management or discharge planning. ... the implementation or investigation of the procedures specified in the Quality Management, Utilization Review and Discharge Planning Program at Westchester… more
    WMCHealth (03/04/25)
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  • Utilization Review Medical Director

    Intermountain Health (Las Vegas, NV)
    …medical review activities pertaining to utilization review , claims review , quality assurance , and medical review of complex, controversial, ... timely documentation and reporting. + Demonstrated knowledge of case management, utilization management, quality management, discharge planning, and other cost… more
    Intermountain Health (03/04/25)
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  • LVN - Quality Assurance

    Emanate Health (Covina, CA)
    …States, and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity… more
    Emanate Health (01/22/25)
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  • Non-Clinical Coding and OASIS Review

    BAYADA Home Health Care (Orlando, FL)
    …should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance , Remote, Home Health ... Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding ...monitoring Outcome and Assessment Information Set (OASIS) documentation for quality and adherence to policies and procedures. As a… more
    BAYADA Home Health Care (04/02/25)
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  • Clinical Coding and OASIS Review Manager

    BAYADA Home Health Care (Orlando, FL)
    …with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance , Remote, Home Health Coding, ... Home Health Care has an immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work remotely. RN, PT, OT, and… more
    BAYADA Home Health Care (04/02/25)
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  • Case Manager Utilization Review

    Beth Israel Lahey Health (Burlington, MA)
    …coordinates utilization review , discharge planning and monitors quality assurance for Lahey Clinic inpatient admissions. Leads the multidisciplinary ... in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital...needed. 10) Supports all service line activities related to utilization and quality management. 11) Assists in… more
    Beth Israel Lahey Health (04/16/25)
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  • Part-Time Weekend Medical Director

    Centene Corporation (Tallahassee, FL)
    quality improvement activities. + Performs medical review activities pertaining to utilization review , quality assurance , and medical review ... + Provides medical expertise in the operation of approved quality improvement and utilization management programs in...with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends… more
    Centene Corporation (04/18/25)
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  • Quality Assurance Coordinator

    MTC (Bryan, TX)
    …co-dependency, and related disorders. 2. Performs complex technical assistance work; implements quality assurance utilization review procedures; and ... and procedures. 3. Assists in monitoring, reviewing, interpreting, and evaluating quality of services; assists in compiling and analyzing data and preparing… more
    MTC (04/18/25)
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