Offres d'emploi
Trouvez des postes près de chez vous, sur site, hybrides ou à distance.- Emplois similaires à : DIR - UTILIZATION REVIEW / MGMT
Utilization Review Coordinator
NeuroPsychiatric HospitalsDaytonAbout UsHealing Body and Mind. NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. Our hospitals use an
Utilization Review Specialist
Umpqua HealthWinstonUtilization Review SpecialistHYBRID, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470 EMPLOYMENT TYPE- Full-Time, Exempt About Umpqua Health At Umpqua Health, we're more than a health
Utilization Review Specialist
St. Charles Health SystemBendRelief, Days Pay range: $27.74 - $41.61 ST. CHARLES HEALTH SYSTEM JOB DESCRIPTION TITLE: Utilization Review Specialist REPORTS TO POSITION: Manager - Utilization Management DEPARTMENT: Utilization Man
Utilization Review Specialist
BriteLife RecoveryEnglewood CliffsWhat you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible for overseeing and coordinating all aspe
Utilization Review Specialist
ICBDLauderdale LakesUtilization Review Specialist – Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K Who We AreExact Billing Solutions is a unique team of revenue cycle managem
Utilization Review Specialist I
Department of Mental Health and Substance Abuse ServicesTulsaUtilization Review Specialist I Join a team that CARES! Here at ODMHSAS, we believe in I.C.A.R.E. – Integrity, Compassion, Accountability, Respect, and Excellence. Our mission is to promote healthy co
Utilization Review Specialist Senior
BayCareFloridaUtilization Review Specialist Senior At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care fac
Utilization Review Analyst - RN
MRINetworkNew YorkBehavioral Health Case Manager Responsible for providing telephonic and e-referral case review and authorization of services utilizing established mental health and substance abuse medical necessity c
Utilization Review Coordinator
Universal Health ServicesAugustaResponsibilitiesLighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15-years. Located in Augusta, GA our 84-bed facility provides a therapeutic setting
PRN Utilization Review Admin
Daymark Recovery ServicesErwinPRN Utilization Review Admin Good Hope Hospital - Erwin, NC 28339 Description Our mission is to inspire and empower people to seek and maintain recovery and health. Daymark Recovery Services, Inc. is
Utilization Review Analyst
Eagleville HospitalNorristownUtilization Review Analyst Eagleville Hospital, an independent substance use and behavioral health treatment and educational organization serving the community for more than a century, provides innova
Utilization Review Specialist
St. Vincent's Hospital WestchesterHarrisonThe UR specialist's primary role is the liaison between the hospitals inpatient and ambulatory services and the managed care organizations. The UR specialist is responsible for a wide range of adminis
Utilization Review Specialist - VNA
Berkshire Health SystemsPittsfieldUtilization Program Specialist The Utilization Program Specialist is responsible for evaluating the necessity and appropriateness of services to ensure that they are effective and cost efficient. The
Utilization Review Nurse RN - NE
LifeBridge HealthRandallstownUtilization Review Nurse RN - NE Randallstown, MD NORTHWEST HOSPITAL NW CARE MANAGEMENT Part-time - Weekends - Weekend shifts - 8:00am-4:30pm RN OTHER 95496 $40.12-$62.19 Experience b
RN Utilization Mgmt, Full-Time Day
Martin Luther King, Jr. Community HospitalLos AngelesPOSITION SUMMARY The RN Utilization Management (RN UM) functions as a support liaisons for a variety of UM functions which may include: the e-TAR process, denials management, and the UM process. Coor
Utilization Review Coordinator (NOT REMOTE)
Universal Health ServicesFayettevilleResponsibilitiesPRN - Registered Nurse (RN): Utilization Review Coordinator Needed !Springwoods Behavioral Health, an 80-bed behavioral health facility located in Fayetteville, Arkansas, provides acut
Utilization Review Specialist Senior
BayCare Health SystemTampaAt BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatie
Utilization Review (UR) Coordinator
New Vista Behavioral HealthJohnstownUtilization Review Coordinator New Vista Health and Wellness is currently recruiting a Utilization Review Coordinator! The New Vista mission: Inspiring Hope, Restoring Peace of Mind, Healing Lives. At
Clinic Utilization Review Specialist
Sidney Regional Medical CenterSidneyJoin our caring community at Sidney Regional Medical Center in Sidney, Nebraska! We are currently pursuing a non-licensed, full-time Clinic Utilization Review Specialist to join our Case Management te
Utilization Review Nurse RN - NE
LifeBridge HealthRandallstownUtilization Review Nurse RN - NE Randallstown, MD NORTHWEST HOSPITAL NW CARE MANAGEMENT Part-time - Weekends - Weekend shifts - 8:00am-4:30pm RN OTHER 95496 $40.12-$62.19 Experience b
RN CASE MANAGER - UTILIZATION REVIEW (PER DIEM)
Valley Health System Consolidated ServicesLas VegasResponsibilities The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with Valley Hospital Medical Center in 1
Utilization Review Specialist - Behavioral Health, SUD Network
Avenues RecoveryLakewoodAvenues Recovery Center is Now Hiring: Utilization Review SpecialistsAvenues Recovery Center is a nationwide network of drug and alcohol rehabilitation centers with eighteen locations across seven sta
Medical Director - Case Management and Utilization Review
Memorial Healthcare SystemHallandale BeachComplexity of Work: Essential Competencies and Skills: Excellent customer service and interpersonal skills. Able to effectively present information, both formal and informal. Strong written and verbal
RN CASE MANAGER - UTILIZATION REVIEW (PER DIEM)
The Valley Health SystemNorth Las VegasResponsibilities The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with Valley Hospital Medical Center in 1
RN CASE MANAGER - UTILIZATION REVIEW (PER DIEM)
The Valley Health SystemParadiseResponsibilities The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with Valley Hospital Medical Center in 1
Utilization Review Coordinator
- Dayton, Ohio, United States
- Dayton, Ohio, United States
À propos
Competitive pay rates Medical, Dental, and Vision Insurance NPH 401(k) plan with up to 4% Company match Employee Assistance Program (EAP) Programs Generous PTO and Time Off Policy Special tuition offers through Capella University Work/life balance with great professional growth opportunities Employee Discounts through LifeMart ResponsibilitiesFiling documents as needed. Initial Precertification with payors. Concurrent Clinical review with payors. Document in the electronic system daily in real time. Admission audit. Ensures that CON's/RON's and CMS certifications are completed by provider.
Consistently demonstrates professionalism with all internal and external customers as evidenced by positive customer and peer Communicates effectively with all staff and patients as evidenced by the establishment and maintenance of productive working relationships. Maintains knowledge of current trends and developments in the field by reading appropriate books; journals and other literature and attending related seminars or conferences. Maintains a professional approach with Assures protection and privacy of health information as attained through written, electronic or oral disclosures. Cooperates and maintains good rapport with nursing staff, medical staff, and other departments. Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital polices that apply. Complies with hospital expectations regarding ethical behavior and standards of conduct. Complies with federal and hospital requirements in the areas of protected health information and patient information. Reconsiderations, assists with appeals as needed, arrange peer to peer level reviews, and report the outcomes to the VP of Care Management and Team. Provides education to nursing staff. leadership team, and providers regarding documentation. Actively works with the business office regarding resolution of appeals/denials and retrospective reviews.
Qualifications Education: Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology required. Master's degree preferred. Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management experience, including discharge planning in a hospital setting required. Licensure: Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. Basic Life Support (BLS) and Handle with Care (HWC) obtained during orientation, if applicable. Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.#INDEEDLOW
Compétences linguistiques
- English
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