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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.
$45 - $70 an hourPart-timeExpandApply NowActive JobUpdated Today - UpvoteDownvote
CASE MANAGER RN - Inpatient Case Management / Float - Part-Time FTE, 10 - Hr. Days 10K Signing Bonus
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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.
$70.43 - $93.34 an hourPart-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Preparing for and providing meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training sessions.
Full-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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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.
$81.02 - $96.24 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Managing Medicare Medical Review and Denials process in conjunction with Director of Rehabilitation, the facility, and therapy staff. Managing Medicare Medical Review and Denials process in conjunction with Director of Rehabilitation, the facility, and therapy staff.
$49 - $56 an hourFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Previous experience in case management and/or utilization review preferred. Responsible for coordinating continuum of care activities for assigned clients and ensuring optimum utilization of resources, service delivery, and compliance with external agencies and referral source requirements.
$29 - $45 a year depends on experienceFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The RN Utilization Review is repsonsible for integrates national standards for case management scope of services including Utilization Management supporting medical necessity and denial prevention, coordination with payers to authorize appropriate level of care and length of stay for medically necessary services required for the patient, compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy.
RemoteExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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The Utilization Review Specialist will also coordinate with appropriate discharge planning processes, providing feedback on documentation processes; and functions as a resource to the clinical team regarding approved criteria, practice guidelines and alternative treatment options.
$45 - $70 an hourPart-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Key responsibilities include evaluating care/services provided, managing resources effectively, and contributing to the annual review of the Case Management/Utilization Management Plan. Knowledge of resource management, Medicare and government payer regulations, quality control, and utilization management processes.
$162,614.41 - $243,776 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Participates in Departmental Quality Assurance activities and Utilization Review activities as requested. Notifies the patient’s attending MD, Podiatrist and other professional persons and responsible staff of significant changes in the patient’s condition in a timely manner.
Full-timeExpandUpdated 2 days ago - UpvoteDownvoteShare Job
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You’ll provide comprehensive and accurate clinical utilization review and dispensing services. Review content and accuracy of drug packaging and labeling. Review for completeness and accuracy of new and refill prescriptions.
Full-timeExpandUpdated 1 month 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.
Full-timeExpandApply NowActive JobUpdated 5 months ago - UpvoteDownvoteShare Job
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2+ years of care management, utilization review or discharge planning experience. Demonstrates a thorough understanding of the cost consequences resulting from care management decisions through utilization of appropriate reports such as Health Plan Eligibility and Benefits and Division of Responsibility (DOR.
$58,300 - $114,300 a yearFull-timeRemoteExpandApply NowActive JobUpdated 5 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.
$221,850 - $366,150 a yearExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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The relief pharmacist will assist in directing professional pharmacists, technicians, students, and support personnel in completing a variety of assignments, such as prescription entry, interpretation and review of prescriptions, drug utilization review, prescriber calls, issue resolution, and filling prescriptions.
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utilization review jobs in Sunnyvale, CA
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