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Job Summary:The Utilization Review Specialist is responsible for the pre-certification, concurrent, and discharge review process for clients at all levels of care, resulting in the approval of their admission and continued treatment.
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San Jose Behavioral Health currently has an opportunity for a Utilization Review Specialist Per Diem, at our new 133 bed Acute Psychiatric Hospital, located in South San Jose, CA. The Utilization Review Specialist coordinates and assesses the inpatient census for appropriate alternate health care service needs.
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Utilization RN - Utilization Review RN - Travel Utilization Review RN, Part-Time, Contract, Travel, Temporary, 13 Weeks, Temp. Tier5, Travel Utilization Review RN Registered Nurse.
$9,369.44 a monthExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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The RN Utilization Review Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. BSN Degree from an accredited nursing program or proven success as Registered Nurse Utilization Review I role.
$31.7 - $42.35 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Staff Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines – Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health.
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Relevant experience includes previous industry, utilization management/utilization review experience and care coordination. This roles supports the Utilization Medical Policy Committee and creates New Technology policies for committee review.
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Licensed to practice medicine in the State of Texas and ten (10) years of progressive management/leadership and patient care experience, practice experience in Telemedicine, Electronic Utilization Review, and Quality Improvement is desirable.
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Ensures compliance with principles of utilization review, hospital policies and external regulatory agencies, Peer Review Organization (PRO), Joint Commission, and payer defined criteria for eligibility.
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When naviHealth is delegated for utilization management, review referral requests that cannot be approved for continued stay and are forward to licensed physicians for review and issuance of the NOMNC when appropriate.
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Utilization Review in Medicare NOMNC/ABN Letters, Medicare Certifications, hospital referral review, evaluation of hospital records for ICD10 coding, setting of ARD dates, etc., of admissions and readmissions, OBRA scheduling, Part B Authorization as needed, CMI Picture Date.
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Avata Partners is seeking a Document Review Attorney in the Austin, Texas Area. While there is software that can aid a document review attorney with this task, he or she must look through the documents and determine what is and isn't relevant to a case.
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Managed care/utilization review experience preferred. Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization. Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program.
$29.1 - $62.31Full-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Span of control includes the following areas: Pre-Admission, Insurance Verification, Pre-Certification, Pre-Service Utilization Review, Centralized and De-Centralized Patient Scheduling, Hospital Registration, Financial Counseling.
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Support UHN initiatives and Quality Affordability Programs as required to achieve the appropriate inpatient and outpatient utilization and affordability goals of the C&S Health Plan and United Clinical Services/ UHC. The Plan CMO has oversight responsibility of the C&S market peer review process as defined by State regulator as well as participating in or leading the Peer Review committee.
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Collaborates with the patient and Utilization Review Team to identify post-acute care options that meet patient needs and assist with information necessary for the Utilization Review Team to obtain timely authorization(s) for services both during and after the patient's hospitalization.
$23.13 - $29.5 an hourFull-timeExpandApply NowActive JobUpdated Yesterday
review utilization jobs Title: associate Company: Bjc Behavioral Health
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