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GENERAL DESCRIPTION: The Utilization Review (UR) Coordinator is responsible for contacting external case managers/managed care organizations for pre-authorization and concurrent reviews throughout the duration of a client’s SUD treatment stay.
$58,500 - $70,000 a yearFull-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. Utilization Management services supporting medical necessity and denial prevention.
Full-timeExpandUpdated 29 days ago - UpvoteDownvoteShare Job
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The Utilization Review Specialist coordinates and assesses the inpatient census for appropriate alternate health care service needs. The Utilization Review Specialist will also coordinate with appropriate discharge planning processes, providing feedback on documentation processes, and functions as a resource to the clinical team regarding approved criteria, practice guidelines and alternative treatment options.
$38 an hourFull-timeExpandUpdated 29 days ago - UpvoteDownvoteShare Job
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The Utilization Review Specialist will also perform pre-certification reviews, concurrent reviews and will perform appeal reviews as needed. Three to Five (5) years experience in Case Management/Utilization Review (as either CADC, LAADC, LCSW, LMHC, LMFT, or Utilization Review Coordinator.
RemoteExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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06 As a Utilization Review Coordinator, you will manage and analyze mental health service data from our electronic health record (EHR) Credible. Please speak to your experience with data review and analysis as well as your experience working with electronic health records.
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Participate in quality assurance and utilization review. LPCC's/LCSW's may be required to supervise LPCA's/CSW's and other associates under supervision. LICENSURE IS REQUIRED (LPCC, LPCA, CSW, LCSW, etc.
$26 - $30 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Location: Baltimore, MD Seeking experienced Utilization Review nurse. Responsibilities Provide health care services regarding admission, case management, discharge planning and utilization review.
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Our Talent Acquisition team is reviewing applications for our Utilization Review Operations Director WFH opening. We are looking for a dedicated Utilization Review Operations Director WFH like you to be a part of our team.
Work from homeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Acute Care Conditions (MACC), Nutrition at Risk (NAR), Utilization Review (UR), Review nursing care plans for each resident that. of Nursing, Health Services Director (Assisted Living), or other regional.
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Attend and/or participate in facility meetings as directed by Center Manager (may include utilization review, infection control, disaster preparedness, etc.) Review Policies & Procedures manual on a yearly basis and adheres to the policies and procedures set forth as well as any updates.
Starting at $18 an hourPart-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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These responsibilities include, but are not limited to, all concurrent utilization review activities as it relates to telephonic review, all clinical pre-certification responsibilities, all retrospective review responsibilities and all insurance company and business office concurrent determination follow-up and communication.
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JOB SUMMARYThe RN Utilization Review coordinates care for OPIS patients who are high cost, complex, and at risk. · Review medical records for knowledge/understanding of situation and resource assessment.
Full-timeExpandUpdated 29 days ago - UpvoteDownvoteShare Job
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Monitor costs, avoidable treatments and resource utilization. Maintains understanding of various payers and Medicare pre-authorization processes. Serves as a liaison between hospital and payer to obtain pre-authorization confirmation and enters into medical record/billing system timely and accurately.
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Communicates with physicians to ensure that correct clinical data is documented to gain proper pre-authorization for third party payers. NCH is transforming into an Advanced Community Healthcare System(TM) and we’re proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan.
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Understands the legal/regulatory requirements related to the release of information. Licensed as a Registered Nurse (RN) in the State of Florida · Minimum of 1 year of experience in a related field required.
Full-timeExpandUpdated 29 days ago
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