- The University of Vermont Health Network (Plattsburgh, NY)
- Unit Description: The Utilization Review Team monitors, collects and analyzes data and evaluates variances of resource utilization , complications and overall ... and promotes the efficient and effective use of patient services. The Utilization Review Team's role in data collection, analysis and summarization supports the… more
- CHRISTUS Health (Alamogordo, NM)
- …Director when there are actual or potential sources of under- or over- utilization . Collaborates with providers, nurses, patients, families, and other care providers ... and assists him/her in ensuring proper placement of patient. Conducts utilization review using nationally recognized medical necessity criteria and documents the… more
- Marion County (Salem, OR)
- …initiate authorization process for requests for Long-Term Psychiatric Care.Ensure accuracy of utilization data of those admitted to the Oregon State Hospital and ... Ensure residential capacity, track referrals, placements, placement/discharge dates, and utilization data is being tracked by Choice team. Provide clinical… more
- CHRISTUS Health (San Antonio, TX)
- …excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically ... to meet the needs of the unit. Assures effective and appropriate utilization of material and human resources, Reviews financial and productivity management reports… more
- CHRISTUS Health (San Antonio, TX)
- …excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically ... to meet the needs of the unit. Assures effective and appropriate utilization of material and human resources, Reviews financial and productivity management reports… more
- Waste Management (Somerset, WI)
- …reliable vehicles are available to meet operational requirements. Manages effective utilization of vehicle assets. Conducts fleet evaluations to ensure maintenance ... standards are met. Ensures maintenance shops are adequately staffed and mechanics are properly trained. Ensures vehicle management systems are effectively utilized. Complies with and ensures adherence to WM's Mission to Zero standards and regulations to… more
- Dana-Farber Cancer Institute (Boston, MA)
- …quality patient experience while maximizing provider time and space utilization . The Nurse Director uses extensive theoretical, evidence-based, and experiential ... knowledge to advance clinical practice, provides clinical leadership and direction, and promotes professional growth for self and staff. The Nurse Director acknowledges the inherent value of nursing collegiality to the advancement of professional practice, and… more
- Marion County (Salem, OR)
- …related to the program services overseen; oversee service planning, coordination, utilization of resources, promote intended goals and outcomes; direct continuous ... quality improvement efforts; establish and maintain effective working relationships with employees countywide, clients, government agencies, community groups/partners, and the public. PHYSICAL REQUIREMENTSOperates a motor vehicle; sees using depth perception;… more
- The University of Vermont Health Network (Elizabethtown, NY)
- …and regulations, clinical practice guidelines, and quality issues related to utilization management with application for appeals and denials management. * Knowledge ... of team/small group principles and dynamics* Demonstrates strong communication (verbal & written) skills and ability to engage and provide education to various sized groups and audience. * Demonstrates a desire to build honest and trustworthy relationships… more
- Saint Francis Health System (Tulsa, OK)
- …toward goals. Facilitates patient discharge through timely, appropriate referrals and utilization of patient education resources, suitable to patient age and ... cultural/psychosocial factors. Collaborates with other disciplines as appropriate. Supports unit/hospital goals through PI and educational activities as evidenced by attending in-services, meeting unit education standards, and completing variance reports.… more
- Dana-Farber Cancer Institute (South Boston, MA)
- …quality patient experience while maximizing provider time and space utilization . The Nurse Director uses extensive theoretical, evidence-based, and experiential ... knowledge to advance clinical practice, provides clinical leadership and direction, and promotes professional growth for self and staff. The Nurse Director acknowledges the inherent value of nursing collegiality to the advancement of professional practice, and… more
- Humana (Columbus, OH)
- …health first** Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management (Behavioral Health) who will utilize their clinical skills to support ... behavioral health services and/or benefit administration determinations. The Manager, Utilization Management (Behavioral Health) applies a Person-Centered approach, works… more
- Centene Corporation (OK)
- …on workplace flexibility. **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care to members. Manages BH ... utilization management issues related to member care, provider interactions,...to member care, provider interactions, and facilitates operations within utilization management. + Manages behavioral health (BH) utilization… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director, Inpatient Utilization Management (UM), leads and manages all utilization management (UM) functions for all ... This role works closely with Medical Directors, and the Vice President of Utilization Management to develop and advance the UM program, collaborates with the… more
- Kelsey-Seybold Clinic (Pearland, TX)
- **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews, benefit verification, and applying criteria to determine ... services requiring authorization prior to services being rendered for members. The Utilization Review Specialist (LVN) serves as a liaison in reviewing requests for… more
- Sharp HealthCare (San Diego, CA)
- …Do** As a member of the System Integrated Care Management (ICM) team the Utilization Manager (UM) II position supports utilization review functions to ensure ... ensuring compliance with all local, state and federal regulations governing utilization review activities and/or care management. Expected outcomes include meeting… more
- UNC Health Care (Chapel Hill, NC)
- …the health and well-being of the unique communities we serve. RN Utilization Manager position specifically for a Utilization Manager/Clinical Appeals Nurse. ... episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Physician Specialist collaborates with the healthcare team in the management and resolution of activities that assure the ... population and HackensackUMC. These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …bonus eligibility, and more! **Responsibilities** **Job Summary / Purpose** The Utilization Management (UM) Director is responsible for the market(s) development, ... implementation, evaluation and direction of the Utilization Management Program and staff in support of the CommonSpirit Health Care Coordination model. The … more
- Beth Israel Lahey Health (Burlington, MA)
- …Center is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three payments. ... **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status… more
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