- UpvoteDownvoteShare Job
- Suggest Revision
Two years of case management or utilization review, billing, or coding experience. Position Summary: Responsible for providing assistance to the Utilization Manager (UM) RN in the coordination of patient admission and continued stay reviews, as well as, performing clerical functions to ensure the efficient operation of the ICM department.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Implements and monitors utilization review process in place to communicate appropriate clinical data to payers to support admission, level of care, length of stay and authorization for post-acute services.
$106,000 - $135,000 a yearExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Maintain PPS board for monitoring of Medicare days and RUGs utilization in the absence of the. Assesses resident through physical assessment, interview and chart review. maintain PPS board for monitoring of Medicare days and RUGs utilization in the absence of the.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
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.
Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Advocates for the patient and hospital with payers to secure appropriate payment for services rendered· Implements and monitors physician “peer to peer” review process with payers to resolve denials or downgrades concurrently.
$106,000 - $135,000ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Technical knowledge of community resources, regulatory requirements, reimbursements and utilization management procedures in order to function as a resource for staff. Oversees submission of cases to Physician Advisor review to ensure timely referral, follow up and documentation.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Serves in a leadership capacity for the following committees: Medical Advisory, Utilization Management, Peer Review, Sentinel Events, Death Review, Behavioral Treatment Advisory Committee, Credentialing Committee, and others as required or directed by the Chief Medical Officer.
$300,000 - $360,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Knowledge of computers, Electronic Health Records, data base systems and utilization review/case management documentation systems. Certification in Case Management (CCM) by the Commission for Case Management Certification (CCMC) or Accredited Case Manager (ACM) by the American Case Management Association preferred.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Department orientation includes review and instruction regarding Tenet Case Management and Compliance policies, InterQual, Transition Management, Utilization Management, and other topics specific to case management.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Conducts daily group therapy sessions with eligible inpatients and Partial program patients and also may perform utilization review for this patient population Provides discharge planning and utilization approvals for post inpatient care.
Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Benefits Package Relocation Assistance Available - Possible Location: Detroit, Michigan. Seniority Level - DirectorMinimum Education - Bachelor's DegreeWillingness to Travel - Occasionally About the area: Detroit, Michigan - Culture awaits, the amazing recreational great lakes and colleges near by.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Master’s degree in Nursing, Business Administration or Hospital Administration preferred. Strong communication and interpersonal skills for frequent contacts with internal customers as well as stakeholders external to the DMC to persuade or negotiate on a wide range of subjects in situations which may be controversial, sensitive and/or lead to confrontation.
$105,000 - $120,000ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. Utilization Management services supporting medical necessity and denial prevention.
ExpandApply NowActive JobUpdated 19 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Accredited Case Manager (ACM) preferred. Leadership skills including demonstrated willingness to pursue leadership roles with increasing levels of accountability, comfort with decision-making responsibilities, coaching, teaching and counseling skills, and the ability to inspire and build confidence in others and to forge alliances and garner support.
$106,000 - $135,000 a yearExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
McKesson InterQual experience preferred. DIRECTOR CASE MANAGEMENT - Full-timeDAYSDirect HireCompetitive Compensation, based on experience. Three to five years of acute hospital case management leadership experience.
$106,000 - $135,000ExpandApply NowActive JobUpdated Today
utilization review jobs in Detroit, MI
FEATURED BLOG POSTS
In-House vs Outsourcing Recruiting: Which is Better?
When looking at in-house vs outsourcing recruiting, it is important to nail down the benefits for each and whether those benefits outweigh the risks that follow.
How to Write a Short Bio
First impressions can be tricky. When meeting someone in person, it’s likely you have an elevator speech. These short, practiced introductions can help you share more about who you are, what you do for work and other facts about you. While this works well in a live, in-person context, there are many cases where professionals “meet” someone via written form - like social media, a resume, or published work. In these cases, your bio works as your first impression. So, here’s a step-by-step guide on how to write a short bio.
How to Conduct a Performance Review (With Examples)
In a world where the smallest mistake can cost your business tens of thousands in lost revenue, your talent is key to keeping your edge on the market and driving growth. However, managing a workforce of any size can be a challenge. Employees come with their own particular skill set, ambitions and flaws. So, it can be difficult to uncover their individual drivers. Not to mention the challenges brought on by the hybrid and remote working models where in-person interactions have become few and far between.
How to Recruit Passive Candidates
Learning to recruit passive candidates is a different ballgame than recruiting active ones. While an active candidate is someone who is currently looking for a new job, a passive candidate tends to be the opposite. Passive candidates are either already working or not looking to work. So, instead of these candidates coming to you, you'll have to find them and reach out to them first.
How to Effectively Recruit Employees
Today, hiring and retaining talent looks much different than it did only two or three years ago. Financial instability and the strain on our mental health brought on by the pandemic has made everyone more wary and selective of their workplace and employer. Whereas in the past people might have prioritized promotions and financial reward, today they look at other factors such as workplace flexibility, personal fulfillment and values alignment.
How Many Hours is Part-Time vs. Full-Time Work?
Growing up you watched your parents shuffle to and from the office, held hostage to their 9 to 5. If jammed-packed schedules and deadlines sound frightening, you might consider pivoting your search to part-time jobs. In fact, even employers have shifted their preference, selecting more people open to the idea of flexible working hours.
How to Make a Job Offer More Competitive
Money alone makes it hard to attract and retain top-notch candidates, especially when you are competing with larger businesses and corporations in your industry. So, instead of focusing on money, figure out how to make a job offer more competitive when you can't offer more money.