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The Utilization Review coordinator performs activities which support the Utilization Management functions. They are responsible for the delivery of the Utilization Management process including but not limited to: making clinical recommendations regarding medical necessity for admission and continues stay, screens patients for client specific guidelines regarding insurance, Medicare and/or Medicaid guidelines, send payor specific Notice of Admission and continued stay reviews.
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The Utilization Management Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. The Utilization Management Nurse III is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services.
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In this position you will coordinate the psychological therapy to aid the patient in identifying a progressive timeline for addressing the causes of addiction. Participate in quality assurance and utilization review.
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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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Interact with insurance companies for pre-certification and utilization management. At Monte Nido Rosewood, we understand the intricate medical, emotional, and psychological complications experienced by someone with an eating disorder.
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Prepare agenda and backup information for management of space requests for the KCTCS Space Utilization Committee. The Asset Management Specialist - Real Estate / Space Utilization (Administrative Associate III) assists with acquisitions and dispositions of real estate, including issuing Intent To Purchase Agreements, ordering surveys, environmental assessments, title searches, review of legal documents and coordination of transaction elements.
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Currently recruiting a Registered Nurse (RN) Case Manager near Palm Springs, California , to provide care to family members of Active Duty heroes in the Wounded, Ill, and Injured Warriors (WII) under the Psychological Health Transition to Care Initiative in the Case Management/Utilization Management Division at Naval Hospital 29 Palms.
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RN Coordinator - Utilization Management & Discharge PlanningSummaCare - 1200 E Market Ave, Akron, OHPart-Time / 20 Hours / Days (2 days one wk / 3 days next wk)RemoteSummary:While taking direction from the Manager of UM, the UM Coordinator helps daily to prioritize, coordinate, and implement utilization, discharge planning, regulatory and compliance activities with the UM team.
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This includes directing processes for threat management teams to forecast and respond to direct threats and support service delivery teams in the field on developing and instituting appropriate response protocols to mitigate anticipated or realized risks; ensuring the training of field-based personnel in evidence-based, data-driven threat assessment and management processes; and championing the utilization of current best-practices within the threat management teams across the service area.
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Bachelors degree in Law Enforcement, Business Administration, Public Policy, Healthcare Management, Criminal Justice, Corporate Security, Security Management, or related field AND minimum ten (10) years of experience in Security Management, Hospital Security, Law Enforcement Management, or directly related field.
$189,300 - $244,860 a yearExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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These services include; psychological assessment, crisis intervention, personal counseling/ psychotherapy, case management, “wellness” workshops, referrals to community services, student, faculty/staff consultations, and staff development activities.
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Job Summary The IT Asset Management Analyst will be responsible for the efficient management, tracking, reclamation, assignment, and auditing of all IT assets within Altice USA. This role will play a crucial part in ensuring the optimal utilization of IT resources, maintaining accurate inventory records, and supporting compliance with company policies and regulatory requirements.
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The LVN Discharge Planner performs utilization review by using criteria that demonstrates medical necessity to achieve reimbursement for services and ensuring appropriate utilization of hospital resources.
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CAPS) provides a variety of mental health and psychological services to UCSC undergraduate and graduate students, including brief individual and group therapy, psycho-educational workshops, crisis intervention, outreach programming, online services, and consultation, to support student academic success and well-being.
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The Manager, UM Regulatory & Compliance - CCA is responsible for the coordination, implementation, and oversight of the IEHP’s overall Utilization Management Out-Patient Operations departmental clinical and operational compliance with regulatory requirements and quality assurance initiatives related to utilization management out-patient activities (e.g., Prior Authorization, UM Call Center operations.
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psychological utilization management jobs Company: Kaiser Permanente
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