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San Jose Behavioral Health currently has an opportunity for a Utilization Review Specialist Per Diem, at our new 133 bed Acute Psychiatric Hospital, located in South San Jose, CA. The Utilization Review Specialist coordinates and assesses the inpatient census for appropriate alternate health care service needs.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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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 Specialist directs all back-office functions of the Case Management Department. Knowledge of utilization management. Maintains audits for timely completion of Utilization Reviews.
Full-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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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.
ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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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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Key Words: RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN. Key Words: RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN.
$3,542 a weekFull-timeExpandApply NowActive JobUpdated 4 days 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.
$95.54 - $113.49 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Educates other healthcare team members on utilization and care coordination. Understands and consistently applies the interpretation, and utilization of member health care benefits. Department : Santa Clara Homestead Hospital - UR-Discharge Planning - 0201.
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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.
RemoteExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Engage with CrowdStrike Sales Enablement team to support sales onboarding and ongoing sales enablement activities and programs, including adoption and utilization of CrowdStrikes Sales Tools & Capabilities.
Full-timeRemoteExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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The intake coordinator role performs end to end processing of Utilization Review referrals, which is the process between indexing to the assignment of the HCP. They will also assist other administrative staff with overflow work, including word processing, data entry and internet research tasks.
$16 - $17 an hourFull-timeRemoteExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Possession of a Registered Nurse license or Bachelors Degree in Nursing AND six (6) months of experience in nursing or other clinical area process improvement, or utilization review/case management in an acute care facility; AND attainment of any AHIMA or ACDIS certification listed above within two (2) years of assignment, or be released from position.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Employ statistical analysis and/or modeling techniques on a variety of data - product telemetry, incidents, user journeys, sales motions, infrastructure utilization, and others, to drive resource optimization, feature improvement, or product adoption-related initiatives.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Knowledge of the models of case management, including the principles and practices of discharge planning, utilization review, and quality assurance/improvement. Major responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness of services as well as appropriate utilization of services; and ensuring optimum use of resources, service delivery, and compliance with external review agencies' requirements.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Advanced knowledge of Case Management and Utilization Review processes, including but not limited to, InterQual and acute-care patient status regulations and guidelines. As the House Supervisor, will be responsible for collecting and analyzing data on patient admissions, transfers, and bed availability in specified clinical areas to improve patient care and maximize bed utilization.
$36.5 - $68ExpandApply NowActive JobUpdated Today
utilization review jobs in Sunnyvale, CA
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