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Researches criteria within utilization computer system in order to monitor inpatient level of care and to facilitate and assist doctor-to-doctor and peer-to-peer review between Hospital and health plan.
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Proven excellent written and verbal communication skillsStrong writing skills, review skills, and general creative “eye”Must be a self-starter with a sense of urgency and a commitment to delivering high-quality work consistentlyExperience with Salesforce, Salesforce Marketing Cloud, print-on-demand systems, and providing creative direction preferred.
RemoteExpandUpdated 6 days ago - UpvoteDownvoteShare Job
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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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Partner with stakeholders: Become a trusted advisor to HR partners by understanding their talent needs and delivering relevant and insightful Talent solutions while also driving company-wide talent review cadence that is tightly aligned to Applied's HR strategy and priorities.
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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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Participate in Patient Care Conferences, Utilization Review meetings and Rehabilitation Conferences as needed. Recommend and facilitate the ordering of necessary durable medical equipment for patients to facilitate independence in mobility; i.e., braces, walkers, canes, elevated toilet seats and grab bars.
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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 2 days ago - UpvoteDownvoteShare Job
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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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Supervisory Requirements Supervises Certified Occupational Therapy Assistant (COTA), aides and students. Qualification Education and/or Experience Bachelor's degree in Occupational Therapy, prefer graduates of Masters or Doctorate Program in Occupational Therapy.
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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.
$33.73 - $43.7 an hourFull-timeExpandUpdated 2 days ago - UpvoteDownvoteShare Job
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Participates in quarterly utilization review and chart audits (peer and self) for OBQI/OBQM as requested by Agency. Supervising LVN/LPN and paraprofessionals providing services at appropriate time frames.
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Reporting: Ensure completion of investor reporting, distributions and monitoring of cash and reserve utilization by the asset management team. Claims Management: Coordinate oversight and tracking of new and open insurance claims, lawsuits, and track outcomes for investor, lender, and executive leadership review.
$122,000 a yearExpandUpdated 2 days ago - UpvoteDownvoteShare Job
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Our Vision is to be the premier provider of post-acute care by perfecting our core competencies. Canyon Springs Post Acute is looking for an Occupational Therapist - PRN. Our Benefits. Record evaluations, daily treatment notes, weekly progress notes, recertification documentation, per Occupational Therapy Board State Practice Act and governmental and third party payer requirements.
Part-timeExpandUpdated 16 days ago - UpvoteDownvoteShare Job
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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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Qualification Education and/or Experience Bachelor's degree in Physical Therapy, prefer graduates of Masters or Doctorate Program in Physical Therapy. Assist nursing department with training of Restorative Aides.
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utilization review jobs in San Jose, CA
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