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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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Clinical professional responsible for facilitating admissions, clinical intake assessments and utilization review processes to assure continuity for the most appropriate level of care for patients and their benefit/resources utilization.
$60 - $69.97 an hourFull-timeExpandUpdated 1 month ago - UpvoteDownvoteShare Job
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Secondary responsibilities include but are not limited to: hardware specification and schematic review, embedded Linux infrastructure, regression and release systems, utilization tracking, regression/release systems, and manufacturing support for a cross-functional team.
$170,700 - $300,200 a yearExpandUpdated 1 month ago - UpvoteDownvoteShare Job
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Participate in Patient Care Conferences, Utilization Review meetings and Rehabilitation Conferences as needed. Supervisory Requirements Supervises Certified Occupational Therapy Assistant (COTA), aides and students.
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Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Alexandria, Louisiana. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 36 hours per week Shift: 8 hours, days Employment Type: Travel We’re seeking talented healthcare professionals whose adventure game is as strong as their clinical game.
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Assists in planning and monitoring managed care utilization review. Designs, implements, and reviews utilization management plans. The following certifications are required: BTLS Provider or Instructor certification, ACLS Instructor certification and PALS Instructor certification.
$102,000 - $125,000 a yearFull-timeExpandUpdated 1 month ago - UpvoteDownvoteShare Job
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Minimum two (2) years of experience in utilization review, case management, and discharge planning preferred. Utilization Management: Performs daily pre-admission, admission, and concurrent utilization reviews using guidelines, institutional policies/procedures, and other information to determine appropriate levels of care and readiness for discharge.
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Review of resource utilization, planning for specialized coverage of all major sales activity areas (Direct, Channel, OEM and Marketing), and review of the resource matching process.
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Quality Program Nurse, RN enforce DHCS regulatory requirements as pertaining to Facility Site Review (FSR) and Medical Record Review (MRR) criteria. Three (3) or more years of any individual or combined experience in Quality Assurance, Utilization Management, Case Management, and/or provider liaison duties, preferably in an HMO or Managed Care setting.
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As a key member of the Public Sector Sales Operations team, the SLED Sales Operations Analyst will leverage a high degree of business acumen to: objectively partner with and guide the sales team on current performance and opportunities; be a key stakeholder in the deal review process; and actively engage in the largest commercial opportunities to deliver customer value and success while maximizing business yields for CrowdStrike.
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Preferred Qualifications: Minimum two (2) years of experience in utilization review, case management, and discharge planning preferred. Educates other healthcare team members on utilization and care coordination.
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Come to sunny Florida and join Palm Beach Health Network as a dedicated Utilization Review Physician Advisor serving two of our premier Florida facilities. Come to sunny Florida and join Palm Beach Health Network as a dedicated Utilization Review Physician Advisor serving two of our premier Florida facilities.
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Thorough knowledge of quality assurance, quality improvement, utilization review, risk management, and accreditation and licensing requirements including The Joint Commission, NCQA, Knox-Keene Act, Federal HMO Act, CMS, Cal-OSHA, Public Employees Medical and Hospital Act, HIPAA and Medi-Cal regulations and standards.
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As an agent of the Health Plan, works with member service directors to ensure the member grievance and complaint process has the appropriate level of qualitative and quantitative review to comply with all legal and regulatory requirements for Hospital/Health Plan.
Full-timeExpandApply NowActive JobUpdated 2 months ago - UpvoteDownvoteShare Job
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Act as a liaison between Medicaid reviewers and the staff completing required paperwork to facilitate the Utilization Review process. May review charts and make necessary recommendations to the physicians, regarding utilization review and specific managed care issues.
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utilization review jobs in Cupertino, CA
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