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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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The Telephonic Case Manager must have the ability to explain medical conditions and treatment plans to the patient, family members and adjuster; supporting the goals of the Case Management department, and of CorVel. This position will have a hybrid work arrangement the first week for training purposes and then eventually transition to remote.
$90,940 a yearExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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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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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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Amity Foundation an internationally acclaimed teaching, and therapeutic community is seeking compassionate and enthusiastic individuals with a desire to teach, learn and join our community as a Utilization Review Specialist at our campus in Tucson, AZ. With this groundbreaking opportunity not only will you be working with our home offices, but you will also be enhancing your training and experience in the field and supporting the growth of our community.
$15 - $18 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Authorization Coordinator works under direction of Social Worker or Case Manager RN.
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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.
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The Utilization Review LVN uses clinical judgement in providing utilization management services. - Preferred 5-7 years of experience in combination of utilization management prior authorization or acute/sub-acute care experience.
$27.77 - $40.27 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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UTILIZATION REVIEW / CASE MANAGEMENT RN - Part Time, Weekends. Position Summary: Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information.
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The Utilization Management Coordinator is responsible for all utilization management activities for assigned cases from admission through discharge, including peer reviews and appeals, in accordance with the Utilization Review Plan, for patient population ages 5 years through 21 years, with significant behavioral health needs and Autism Spectrum Disorders or other developmental disorders.
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The Utilization Review RN Coordinates continuing care/outside services for value based risk members (HMO members) in collaboration with the hospital and primary care physician. As a part of the Utilization Management team the Utilization Review RN is a member of the Care Coordination team.
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Strong cost containment background, such as utilization review or managed care helpful. The Telephonic Case Manager must have the ability to explain medical conditions and treatment plans to the patient, family members and adjuster; supporting the goals of the Case Management department, and of CorVel.
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Must have 2 years working in a hospital and 2 years of utilization review (UR) experience in a hospital or insurance company. Uses clinical and analytical skills to review and interpret diagnostic test results to determine appropriateness of patient's level of care.
$68,224 - $104,811.2 a year depends on experienceFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Piper Companies is currently seeking a Remote Utilization Management Nurse for a remote opportunity within a health insurance organization. Responsibilities of the Remote Utilization Management Nurse:Responsible for performing medical reviews to assess, and coordinate quality care for patientsDetermine medical necessity utilizing MCG criteria and medical policy/contractual benefits.
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Experience using Jack Henry/Silverlake, Global Wave Portfolio Track and DiCOM Loan Review software preferred, but not required. Experience:A minimum of three (3) years of commercial credit experience and five (5) years of combined commercial lending, commercial credit, special assets, and/or loan review experience required.
$58,500 - $88,000 a yearFull-timeExpandApply NowActive JobUpdated Today
Title: utilization review Company: Corvel
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