required with preferred experience in critical care areas: Required Two years' utilization review experience using the Optum/Inter... with timeliness and accuracy. Follows all departmental workflows in communication variances to the on-site care management teams when...
corrective action plan for areas of improvement identified through utilization review, clinical records audit, claim denials... utilization of systems for granting or terminating clinical privileges, professional staff or medical staff or clinical staff...
: Responsible for the quality and resource management of all patients that are admitted to the facility from the point... of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment...
Responsibilities Responsible for the quality and resource management of all patients that are admitted to the... facility from the point of their admission and across the continuum of the health care management. Works on behalf of the...
. What You’ll Be Doing Utilization Management & Medical Necessity Review Performing physician-level utilization management... to behavioral health utilization management Assisting with the development, review, or refinement of utilization management...
Utilization Management Nurse will report to the FEP Utilization and Medical Review Manager. In this role you will be part... of a dynamic team responsible for prior authorization and concurrent review medical reviews. You will ensure members receive...
Anticipated End Date: 2026-01-24 Position Title: Utilization Management Representative II... Job Description: Utilization Management Representative II A proud member of the Elevance Health family of companies, Carelon Behavioral Health...
: Utilization Management Physical Strength: Light (L) Reports To: Utilization Management Manager Work Location Type: Hybrid... The Clinical Support Specialist - Utilization Management (CSS-UM) will work in-person and remotely to perform all aspects...
Utilization Management Nurses and associated programs and processes, as directed by the Senior Manager, Patient Review and Intake..., Patient Review & Intake Services or Manager, Utilization Management to: Manage team responsible for completing utilization...
with the Utilization Management Nurse Manager to identify patient utilization trends to assist the Bassett Healthcare Network... determines are necessary or desirable to meet its business needs Assist and support the Director and Utilization Management...
with the Utilization Management Nurse Manager to identify patient utilization trends to assist the Bassett Healthcare Network... determines are necessary or desirable to meet its business needs Assist and support the Director and Utilization Management...
and timely implementation of plan of care in accordance with hospital(s) Utilization Review Plan and CMS regulation. Maintains... as assigned. Supervisory/Management Responsibility This is a non-management job that will report to a supervisor, manager...
Anticipated End Date: 2026-01-20 Position Title: Utilization Management Representative... I Job Description: Utilization Management Representative I Location: This role enables associates to work virtually full-time, with the exception...
Health Hospital Phoenix is seeking a dynamic and talented Utilization Management Coordinator to join our team... - Monday to Friday - NO WEEKENDS / DAY SHIFT Website: Qualifications Duties and Responsibilities: Review the treatment...
Health Hospital Phoenix is seeking a dynamic and talented Utilization Management Coordinator to join our team... - Monday to Friday - NO WEEKENDS / DAY SHIFT Website: Qualifications Duties and Responsibilities: Review the treatment...
Manager, is responsible for the hospital-wide Utilization Management Programs in a general acute care hospital which serves...Job Category: Revenue_Cycle Job Description: Under broad direction from the Centralized Utilization Management...
About this Job: General Summary of Position Supervises the daily activities of the Utilization Review Team. Manages... as a resource and mentor to the Utilization Review staff. Primary Duties and Responsibilities Supervises daily activities...
Anticipated End Date: 2026-02-06 Position Title: Utilization Management Medical Director – Indiana Medicaid... Job Description: Utilization Management Medical Director – Indiana Medicaid Location: This role enables associates to work virtually full-time...
utilization review/utilization management experience preferred. Familiarity with manager health care process, medical terminology..., experience in case management, discharge planning, and/or utilization review preferred. EEO Statement All UHS subsidiaries...
utilization review/utilization management experience preferred. Familiarity with manager health care process, medical terminology..., experience in case management, discharge planning, and/or utilization review preferred. EEO Statement All UHS subsidiaries...