- UpvoteDownvoteShare Job
- Suggest Revision
Minimum 4 years experience in nursing in an acute care setting through direct patient care, utilization review, case management or quality review with passing score on clinical competency assessment.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Knowledge of insurance, utilization review, scheduling requirements and support of front desk responsibilities. Follows policy and procedure for entering of OCM and utilization of IDX. Completes work within assigned hours.
ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Our focus is Utilization Review with care coordination of our patients and some discharge planning. Our purpose is to provide high quality care through appropriate resource allocation, to assure effective and efficient utilization of hospital facilities and services and help facilitate improving maximum financial strength for the hospital system.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Job DescriptionFacilitates quality and efficient patient intake process through pre-registration, registration, insurance, precertification verification, document completion, POS collections, and work output review.
$15.75 - $21.26 an hourPart-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Preferred Qualifications: Bachelor's degree Nursing 1 year Case management or utilization review experience within the last three years preferred. The RN case manager role integrates the functions of utilization management, quality management, discharge planning assessment, and coordination of post-hospital care services, including transfers to an alternative level of care.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Review historical production rates, material pricing, and equipment utilization. Ability to understand and use multiple platforms (internally and externally) to manage projects (HCSS, Bluebeam, etc.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Support an ongoing review process for the standard operating procedures and guidelines for equipment reliability and breakdown management, which will support APMT in sustaining safe operation of all terminal equipmentExercise management authority to promote total-terminal success in accordance with the leadership’s strategic vision, including optimization of work processes and efficient manpower utilization.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Troubleshoot utilization review and medical necessity related issues utilizing AMM or other UR vendor's website information, and route claims for review accordingly. The Medical Claims Adjuster is responsible for the review, investigation, decision making, and processing of production claim types, and all related claim functions and activities.
RemoteExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
ESSENTIAL DUTIESThe primary responsibility of the Utilization Review Specialist is to review medical records and prepare clinical appeals (when appropriate) on medical necessity, level of care, length of stay, authorizations and denials for patients.
$56,305 - $69,201 a yearFull-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.
ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Understanding of drug utilization review and drug usage evaluation. Provides education to providers and staff via presentations, newsletters, formal utilization reviews, and one-on-one interactions.
$91.12 - $93.86 an hourFull-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Prepare pre-certification/authorization information to insurance utilization review team and subsequent concurrent review (continued stay) clinical reports per medical necessity criteria.
$68,000 - $90,000 a yearFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Facilitates the utilization of resources to meet patient outcomes and contribute to Facility (AMC), New York State and National Quality data metrics. Performs review and triage of incoming test results, patient requests and pharmacy renewals; facilitates call-backs to patients as necessary.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
3 years of hospital-based Case Management experience including Utilization Review and Discharge Planning experience. Coordinates and participates in hospital utilization review process.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Demonstrate and maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. As necessary, assist pre-certification nurses and other staff in understanding the principles behind appropriate utilization of covered treatments and genetic testing.
Full-timeExpandApply NowActive JobUpdated 3 days ago
utilization review jobs
FEATURED BLOG POSTS
What is Your Desired Job Title?
You’ve decided to look for a new job. So now comes the question — what is your desired job title? There are lots of considerations to think through when deciding on the right title for your next role.
4 Things to Consider When Building a Global Workforce
The rise of remote work has given employers a unique chance to rethink how they approach workforce management. This ranges from rethinking the size and design of their office space to updating their tech stack to accommodate different working styles. It has created new opportunities for companies of all sizes to expand their hiring pool and look for top talent on a global scale.
Operations Job Titles for Entry, Mid, and Senior-Level Positions
An operations team can take on many functions within a business. With wide-ranging responsibilities come wide-ranging job titles. This means that you have to be more vigilant in your job search. On one hand, the perfect job might be hidden under a title you might not expect. Meanwhile, operations titles that you’re used to looking at may mean something different at a given organization depending on their structure.
How to Automate Your Job Search
The internet is ripe with career professionals urging you to be aggressive in your networking and application strategies to land a job. But at what expense? Your sanity? Peace of mind? Energy? Free time? When the job search gets overwhelming—as it inevitably will—leverage automation to take the most tedious tasks off your plate. Here are seven ways to do it.
How To Request Accommodations at Work (According to Someone Who’s Done It)
Doing a job for eight hours a day, five days a week is exhausting for anyone. But for those with a disability or chronic pain, it can be especially taxing—something must change. Asking for reasonable accommodations at work can feel tricky, especially if you’re new to the job. Under the Americans with Disabilities Act (ADA), physical disabilities, health conditions, and symptoms of mental health are all valid workplace accommodations. When you request accommodations, it means that your condition is impacting your ability to perform at work.
Finally! Answers to 9 Job Search Questions You've Been Wondering About
There’s no college course on how to job search effectively. If schools offered “Job Searching: 101,” we wouldn’t have to write this article. Unfortunately, there’s nothing straightforward about a job hunt, and researching the best job searching methods is basically limited to sourcing peer advice and internet articles. Don’t worry; we’ve got your back. Here are definitive answers to the most common questions you’ve been dying to ask.
How to Successfully Make a Career Change in the New Year
The beginning of a new year is often a time for reflection and introspection. Millions of people use this time to come up with new resolutions to help them live happier and healthier lives. Pursuing our career ambitions is among the top five, right up there with exercising more and eating better.