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Performs prior authorization, precertification, and retrospective reviews and prepares decision letters as needed in support of the utilization review contract Assists management with training new Nurse Reviewers to include daily monitoring, mentoring, feedback and education.
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Design, document, develop and roll out financial, clinical and utilization analyses using a variety of computing tools (e.g., SQL, Excel). Designs, documents, develops and rolls out financial, clinical and utilization analyses using a variety of computing tools (e.g. SQL, Excel.
RemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation.
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Two (2) or more years of experience performing utilization review, charge audits, case management, clinical documentation or similar functions in an acute care hospital. Cheyenne Regional Medical Center was founded in 1867 as a tent hospital by the Union Pacific Railroad to treat workers injured while building the transcontinental railroad.
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Proficient in use of Engineering Software, eg Hysys, ProII, Aspen+ Relevant syngas experience, (both in production via reforming technologies or in downstream utilization) Degree / PhD in Chemical Engineering - (PhD desired.
ExpandApply NowActive JobUpdated 15 days ago - UpvoteDownvoteShare Job
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Knowledge of coding and billing such as E/M level charges, and coding for DRG audits. The Nurse Auditor reviews medical records for hospital clients to review including denials, disallowed charges and more for the facility.
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Develop and implement high-level measurement across all partnerships - Design systems and dashboards to accurately measure partnerships and regularly update the leadership team on progress; this will include establishment of KPIs related to expected performance including utilization, penetration of target markets and others, as appropriate to the product and opportunity; act proactively if KPIs are not on track in order to trouble shoot and correct early to drive success.
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The RN coordinates with the Primary Care Provider and all other members of the health care team to support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes.
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Directly supervise PTA and Rehab Tech in skilled tasks during group and individual treatment in a manner that promotes efficient and effective utilization of resources and facilitates the ongoing development of clinical skills in accordance with State Practice Acts, Omnibus Reconciliation Act (OBRA), and Reliant Rehabilitation policy.
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4) Represents the Chief of Maintenance in coordinating actions such as aircraft and equipment utilization, sortie rates, flying hours and simulator utilization with the Air Commander, Operations and other members of the flight scheduling committee.
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The Supply Lead will report to Program and Amentum leadership and will be responsible for the performance of limited aspects of technical supply management work (e.g. inventory management, storage management, cataloging, property utilization, and Procurement) related to depot, local, or other supply activities.
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Experience with telematics tools and utilization of fleet data to determine loss causation and mitigation opportunities. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals.
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Adjust locomotive consist requirements based on HP and trailing tons daily, with a goal to minimize locomotive fuel and maximize locomotive utilization. The Trainmaster supervises and coordinates activities of train crew engaged in switching railroad cars within yard of railroad, industrial plant, or similar location to facilitate loading or unloading of cars or making up and breaking up of trains; and/or switches railroad cars within yard of railroad, industrial plant, or similar location to load and unload cars or to make up or break up trains in a safe and efficient manner.
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Establish and maintain knowledge on the local and national payer landscape, including Specialty Pharmacy and Utilization Management criteria for Dupixent. The Field Reimbursement Manager (FRM) will be the field subject matter expert relating to patient support, access, reimbursement, prior authorization, appeal, financial assistance, and other business related issues within the Dupixent Business Unit.
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Estimate Vetting Project Candidates, Utilization Management of Project Team & can help across Practice. Banking Technology Sr Manager Remote - USA,USA This position supports the Business Consulting practice at SolomonEdwardsGroup focused on technology solutions and enablement for the commercial and retail banking industry.
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utilization job in Cheyenne, WY
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