Job Posting Title Utilization Review Specialist Agency 452 MENTAL HEALTH AND SUBSTANCE ABUSE SERV. Supervisory... Utilization Review (UR) Specialist helps to manage the facility’s utilization management processes. This includes preparing...
About the Position: Under general direction of the Director of Operations, the Utilization Review (UR) Specialist... of Operations and the medical, clinical and reimbursement staff to reduce the potential loss of collections. The UR Specialist...
Peer Review Specialist facilitates provider peer review processes at a regional level. Job Description Assists in the... monitoring, utilizing defined guidelines and criteria of the Medical Staff. Gathers clinical data, prepares summary reports...
so you can provide exceptional care to others. As a Utilization Review Specialist joining our team, you're embracing a vital... Specialist who excels in this role: Displays knowledge of clinical criteria, managed care requirements for inpatient...
or requested. EXPERIENCE Required 3 years of experience in Clinical setting 3 years of experience in Medical claim review...Company : Highmark Inc. Job Description : JOB SUMMARY This role involves an indepth review of provider submitted...
: As a Medical Review Specialist V (Medical Reviewer V), you will review and analyze Medicare claims sampled by the Department... records review, summarizing claim determinations, clinical observations and other information requested by the DOJ based...
As a Medical Review Specialist V (Medical Reviewer V), you will review and analyze Medicare claims sampled by the... records review, summarizing claim determinations, clinical observations and other information requested by the DOJ based...
Position Summary: The Utilization Review Specialist/Outcomes Specialist conducts concurrent and retrospective review... functions in support of the hospital Utilization Review Program and makes appropriate referrals to designated Physician Advisors...
Review Specialist-RN provides consultative services regarding quality assessment and trends to medical staff and to hospital... Minimum Education: High School Diploma or Equivalent Minimum Years of Experience: 4 Years of clinical or hospital experience...
Position Summary: The Utilization Review Specialist/Outcomes Specialist conducts concurrent and retrospective review... functions in support of the hospital Utilization Review Program and makes appropriate referrals to designated Physician Advisors...
professionals, providing the Right Care, at the Right Time, in the Right Place. Job Description: Clinical Team Specialist/Oasis... Review Nurse Specialist At Elara Caring, we care where you are and believe the best place for your care is where you live...
! How you'll contribute The Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued.... Responsibilities: Displays knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization...
contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR... knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization and advocates on behalf...
STGi is currently seeking a Medical Assistant-Case Review Specialist to support our Federal Occupational Health (FOH... Specialist for the case review process to include ensuring exam scheduling, appropriate management and processing of all medical...
: Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care services with the goal... medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical...
Utilization Review Specialist is responsible for managing and coordinating the utilization review process for inpatient..., and effective communication with managed care organizations. The Specialist works collaboratively with clinical teams, the...
. REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS State of Work Location: Illinois Certificate for OASIS Specialist-Clinical (COS-C...) - OASIS Certificate & Competency Board - OASIS Certificate & Competency Board Or Home Care Clinical Specialist - OASIS (HCS...
. How you'll contribute An Utilization Review Specialist who excels in this role: Displays knowledge of clinical criteria... Review Specialist joining our team, you're embracing a vital mission dedicated to making communities healthier...
Position Summary: Under the direct supervision of the HIM manager, the UR specialist monitors the utilization... setting and status. Collection of clinical information necessary to initiate commercial payer authorization. Obtain...
across all cancer types. About the Role The Case Review Specialist ensures that case documentation is provided by the provider... 14 million people in the US and Puerto Rico, OncoHealth offers digital solutions for treatment review and virtual care...