and safety. Thank you for considering our Utilization Review Manager position as we continue our successful opening...! More information about Southridge can be found online at: Position Description: The Utilization Manager is responsible...
. Licensure: CA RN license required. License in Social Work, AMFT, Mental Health Counseling preferred Experience: A minimum of 3...-5 years of experience working in an acute inpatient psychiatric setting as a treatment team member and/or utilization...
. Licensure: CA RN license required. License in Social Work, AMFT, Mental Health Counseling preferred Experience: A minimum of 3...-5 years of experience working in an acute inpatient psychiatric setting as a treatment team member and/or utilization...
identified as having the need for inpatient/outpatient precertification. ESSENTIAL DUTIES & RESPONSIBILITIES Review... precertification requests for medical necessity, referring to the Medical Director those that require additional expertise. Review...
, and other internal and external teams. The goal of this partnership is to improve utilization review processes, improve efficiency... strategic and operational leadership. This leadership is for SFHP's Utilization Management (UM) program, ensuring members...
in either Case Management or Utilization Management. Responsibilities Review patient files and treatment information... There are five new RN vacancies at the West Los Angeles VA Medical Center. Service Line | Unit | Position Title | Tour...
PURPOSE STATEMENT: Monitor utilization of services and optimize reimbursement for the facility while maximizing use... companies for inpatient treatment and continue to obtain authorizations for duration of patient stay. Evaluate the utilization...
Director of Utilization Management provides strategic leadership, oversight and operational management for all utilization... review and medical necessity processes within the health system. This role ensures patient care is delivered at the...
of community investment What You Will Do Provide strategic and operational leadership for Case Management, Utilization Review... of: Prospective payment systems Managed care Utilization review Discharge planning CDI and mid-revenue cycle Payor relations...
seeking an experienced Utilization Review Nurse who will serve as an integral contributor in the delivery of AwareUM...ABOUT THIS POSITION The Clinical Product Consultant for Utilization Management is a member of the Customer Success...
oriented atmosphere. Responsibilities Reviews medical records and attends treatment team meetings to review utilization... is looking for a Utilization Management Reviewer to monitor the utilization of clinical services provided at Mental Health Resource Center (MHRC...
: As a Utilization Management Nurse, you will have a meaningful impact each day by delivering comprehensive, patient centered care..., expand your clinical thinking, and grow your expertise over time. Things You’ll Do Here: Review prospective, concurrent...
, retrospective review, bed status management, resource utilization management, regulatory compliance, and related denial management... here. This position is responsible for performing the daily operations of the Utilization Management program at AnMed within the Care...
review experience No active California RN license Inability to work autonomously Inability to commit to no time off...Job Description: Job Title: Clinical Review Nurse - Concurrent Review Duration: 12 months (Possible Extensions...
***This is a fully remote role but candidates must have a valid RN license in Illinois*** Position Purpose: Care Review Clinician works... with the Utilization Management team primarily responsible for medical necessity/utilization review aimed at providing members...
Residential Review, and other compliance reviews). Analyzes and reports significant utilization trends, patterns, and impact.... What you will do: We are looking for a SENIOR DIRECTOR OF MEDICAL REVIEW who can help shape our vision and support our mission. Here is what the position will look...
for the appeal Ensures timely review, processing, and response to appeal in accordance with State, Federal and NCQA standards... regulations preferred. Knowledge of utilization management processes preferred. License/Certification: LPN - Licensed...
Remote Clinical Review Nurse – Prior Authorization Location: Must be located in Central or Eastern time zones... all review decisions clearly, accurately, and in compliance with regulatory and organizational standards. Maintain up...
Remote Clinical Review Nurse – Prior Authorization Location: Must be located in Central or Eastern time zones... all review decisions clearly, accurately, and in compliance with regulatory and organizational standards. Maintain up...
Remote Clinical Review Nurse – Prior Authorization Location: Must be located in Central or Eastern time zones... all review decisions clearly, accurately, and in compliance with regulatory and organizational standards. Maintain up...