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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.
$33.66ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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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 Utilization Review RN utilizes his/her skills to coordinate internal and external resources to facilitate appropriate resource management of an age specific patient population which spans from newborns to geriatrics, identifying opportunities for process improvement, high risk cases and sentinel events, to the achievement of an acceptable outcome.
$35.43 - $52.44 an hourPart-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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The utilization management coordinator LPN role is to ensure that health care services are administered with quality, drug cost efficiency, and compliant with payer policy. Utilization Management or Case Management certification preferred.
$21.02 - $36.96 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Serves as a liaison with headquarters, TRICARE regional offices, MTF staff and professional organizations concerning Utilization Management practices. Completes all required electronic medical record training, MTF-specific orientation and training programs, and any AF/DoD mandated Utilization Management training.
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May participate in special studies relating to Utilization Review and Quality Assurance. Extrapolates requested medical information from records for Utilization Review and other committees and may otherwise participate as a member of the committee(s.
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Supervises utilization management personnel and oversee all utilization management functions, including inpatient admissions, concurrent review, prior authorization, and referrals to care management.
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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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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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Actively participates in the Utilization Management committee. Utilization Review- RN Reviewer- Regional Coverage for Loyola, Gottlieb and MacNeal Hospitals. The Regional Utilization Review Documentation Specialist nurse works with the multidisciplinary team including physicians, staff and payers to ensure patient's progress along the continuum of care in an efficient and cost-effective manner that ensures quality outcomes.
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Looking for a fellowship trained, experienced, and business minded advanced Interventional pain management physician. Pain Management Physician, Pain Management, Chronic Pain, Acute Pain, Physician, Healthcare, Health Care, Patient Care, Hospital, Medical, Doctor, Md.
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The UR Supervisor will be responsible for reviewing and/or completing all necessary appeals and engaging in denial trend reviews and root cause analysis of such with the Utilization Review Director.
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Under the supervision of the Budget Director, the Financial Management Analyst is responsible for leading financial and data analysis work to support transparent and innovative budget, multi-year forecasting and reporting.
$75,536 - $109,526 a yearExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Coordinator, Property Management is the staff member support the Property Management team in coordination of repairs and maintenance. We pride ourselves in providing a full breadth of management services to provide quality, safe, and affordable housing; maintenance; financial reporting; and resident relations.
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Verbal and written communication skills including discussing medical needs with members and interfacing with internal staff/management and external vendors and community resources. Job Summary This position is responsible for conducting medical management and health education programs for customers on government health care programs.
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Title: utilization management Company: Santa Clara Family Health Plan
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