of care. Presentations to Medical Staff, Board, Administration as needed. Chairs or serves on the Utilization Management... evaluation of the hospital utilization management program. Maintains current knowledge of federal, state, and payer regulatory...
, Administration as needed. Chairs or serves on the Utilization Management Committee. Participates in the peer review process; makes... suggestions on ways to improve this process. Assists with the evaluation of the hospital utilization management program...
complex cases 4. Responsible for utilization management. a. Performs Interqual review of acute and outpatient admissions... Utilization Management Plan. (If no resolution to non acute admission/stay.) h. Completes data collection and clinical reviews...
. Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management... is required. Requirements As Physician Reviewer/Advisor supporting Dane Street Legal Services IMEs, the physician reviews medical records...
utilization nurses Follows all departmental policies and workflows in end-to-end management of cases. Participates in team... utilization review activities, including pre-certification, concurrent and retrospective reviews according to guidelines...
data mining techniques to identify improvements and address emerging data trends. Oversees the management of reporting... initiatives, programs, and systems that enhance operational efficiency and data utilization. Acts as a mentor and quality...
: Outpatient Case Management, NaviCare, ACO) and/or other community services according to department protocol Collaborates... with attending physicians and health care professionals regarding appropriate utilization of medical services Completes level...
the daily operations of a department including staff training, development, and performance review, utilization... in field of expertise. Terracon Authorized Project Reviewer status preferred. Exemption Exempt Requisition ID 34465BR...
practice with medical necessity and utilization review/management expertise Expanded credentials as an expert in Independent.... We are searching for providers throughout the state of California. Requirements: As Physician Reviewer/Advisor, you will utilize...
the daily operations of a department including staff training, development, and performance review, utilization... of expertise. Terracon Authorized Project Reviewer status preferred. Exemption Exempt Requisition ID 34463BR Employment...
the daily operations of a department including staff training, development, and performance review, utilization.... Preferred Certification: Certification or licensure in field of expertise. Terracon Authorized Project Reviewer status...
practice with medical necessity and utilization review/management expertise Expanded credentials as an expert in Independent.... We are searching for providers throughout the state of Alaska. Requirements: As Physician Reviewer/Advisor, you will utilize...
. Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management... Surgery Spine is required. Requirements: As Physician Reviewer/Advisor supporting Dane Street Legal Services IMEs, the...
. Stay for the culture. What You’ll Be Doing: Job Description Cardiovascular Utilization Management Reviewer...? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional...
utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical... activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support...
, this position integrates utilization management with collaborative engagement and innovation. Core Responsibilities Clinical... Review & Peer Collaboration Serve as the physician reviewer for oncology cases that do not initially meet medical necessity...
. Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management... Surgery Spine is required. Requirements: As Physician Reviewer/Advisor supporting Dane Street Legal Services IMEs, the...
practice with medical necessity and utilization review/management expertise Expanded credentials as an expert in Independent.... We are searching for providers throughout the state of Oregon. Requirements: As Physician Reviewer/Advisor, you will utilize...
. Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management... Surgery is required. Requirements: As Physician Reviewer/Advisor supporting Dane Street Legal Services IMEs, the physician...
and utilization management reviews for specialty medications, to include site of care assessments, for enrollees of Quantum Health... documentation, and other clinical resources to achieve proper decisions in utilization management reviews. The Pre-Certification...