Utilization Review Manager - Healthcare Quality & Appeals
Memorial Physician Practices
Sycamore Springs in Layfette, IN is seeking a UR Manager to oversee utilization review activities in a psychiatric facility and to handle precertification, recertification, peer-to-peer reviews, and appeals. The UR Manager will report to the Director of Finance and supervise the UR team. Responsibilities include ensuring certifications, coordinating with clinical services and payers, and accurately reporting denials to leadership. #J-18808-Ljbffr Memorial Physician Practices
- ...provide operational supervision of clinical staff performing utilization reviews and specialty reviews using InterQual criteria. You will... ...work model with occasional on-site collaboration, based out of Oregon, serving diverse healthcare #J-18808-Ljbffr Comagine HealthSuggestedRemote jobFlexible hours
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$200k - $250k
...a Medical Director of Quality - Heart & Vascular West... ...largest integrated healthcare system in New Jersey,... ...oversee clinical event reviews and regulatory compliance... ...care reliability. Utilize data analytics and registry... ..., and change management skills. Proven ability...Suggested- ...Quality Management Manager Kings County Hospital Center has a rich legacy for its pioneering... ...Hospital Center continues to be a leading healthcare facility whose mission is to provide... ...projects, workflow processes, and review and/or creation of policies and procedures...SuggestedWork at officeShift work
$120k
...CareHudson Regional Health is a newly unified healthcare network serving Hudson County through... ...What You'll Be Doing The Director of Quality and Performance Improvement will be... ...efficient operations. Develops programs to review and evaluate patient care and outcomes....SuggestedFull timeLocal area- ...team as a day-shift, full-time, Quality & Patient Safety Director of... ...-First Environment and Make Healthcare Better We empower our team... ...Collaborates closely with Risk Management, Compliance, Patient Safety,... ...methodology, and/or clinical chart review and abstraction experience....Full timeDay shift
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$81.65k - $112.7k
...change and shapes the future of healthcare. Thinking differently is what... .../GLP standards, and company quality system procedures while... ...suitability, troubleshooting, and data review activities. Provide... ..., mentoring, and performance management for laboratory personnel. Assign...Contract workTemporary workWork at office- ...Full Info and Map Whole Health Clinical Quality Manager Minimum Qualifications In order for... ...Mental Health Counseling, Psychology, Healthcare Administration, Nursing, or a related field... ...must authorize and cooperate with these reviews as part of the hiring process. Tompkins...
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...published more than 35 peer-reviewed studies, and delivered unmatched... ...combining the highest-quality care and technology solutions... ...passion for clinical quality and management. The ideal candidate brings... ...that include: Comprehensive healthcare coverage (including medical,...Full timeRemote work$96k - $113k
...reimagining the way we help customers to manage risk. Join us as Underwriting Quality Manager to play your part in that... ...across all legal entities. Review underwriting quality, pricing compliance, portfolio management utilization, management controls and provide senior...Full timeWork experience placementWork at officeLocal areaHome office$110k - $145k
...Power is seeking a Laboratory Manager to lead a team that supports... ...instructions and best practices. Utilize proven employee management... ...maintain the laboratory's quality management system (QMS),... ...disposal of samples/materials. Review and approve validation...Work at officeVisa sponsorshipWork visa$30 - $35 per hour
...or an alternative application process. Quality Manager Full Time Quality Clovis, NM, US 26 days... ...comprehensive support including site reviews, due diligence studies, and navigating... ...Skills: The Quality Technician/Manager utilizes measurement and inspection skills daily...Hourly payFull timeContract workFor contractors- ...Description Job summary This is a mid-level Quality position responsible for managing all aspects of Quality across and... ...annual Executive Management reviews. Manage ISO audits and drive audit... ...customers and timely closure of claims. Utilize and analyze data to drive...
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...Hotmail) or conduct interviews utilizing video chat rooms. We will... ...participant- and plan-level audits and review, and oversee offshore vendor... ...you'll be doing You will manage a team of early to mid-career... ...responsible for conducting quality audits, balancing workloads,...Work experience placementWork at officeRemote workWork from homeRelocation package$110k - $118k
...Behavioral Health Quality Manager The Behavioral Health Quality Manager ensures behavioral health programs meet high standards of patient... ..., or regulatory compliance in behavioral health or healthcare settings. ~ Knowledge of OMH, OASAS, OPWDD, NYS Justice Center...- ...Description: The Director of Quality is responsible for... ..., and performance management program for the Joseph... ...Coordinators. Develop, review, and update Quality... ...support clinical team utilization, pre-visit planning,... ...Bachelor’s degree in healthcare administration, public...Contract workWork at officeAfternoon shift
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$112.7k - $193.2k
...successful candidate for Senior Consultant, Quality Measurement will be an established and... ...Medicaid Services (CMS), the Agency for Healthcare Research and Quality, and the National... ...based organizations such as NQF Draft and manage proposals for new projects related to...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal areaMonday to Friday$70k - $85k
...direction and supervision to quality assurance and laboratory employees... ...conjunction with the quality manager, help build and maintain an... ...required quality record review such as laboratory documentation... ...product performance and utilize statistical process control (...Hourly payWork at office$91.7k - $150.8k
## Manager, QualityApplyremote type: In-personlocations: Wallingford, CTtime type: Full timeposted... ...Summary:**Position will manage the Quality Management System activities of Bio-... ...conducting performance discussions* Write, review & approve the following as appropriate: SOP...Temporary workInternshipWorldwideFlexible hours- ...Quality Assurance Manager Functional Purpose: Develops, recommends, and implements realty asset programs... .... # Performs market research and reviews comparative analysis on real estate... ...values of leased facilities and prepares appeals as necessary. Manages commission...Contract workFor contractorsLocal area
$117.4k - $177.6k
## Internal Audit Manager - Quality & OperationsApply: Office - Flexible: Indiana - Indianapolis... ...to meet its goals through independent reviews and assessments of the company’s... ...owning capacity planning, allocation, utilization, and schedule accuracy.* **Bring the team...Full timeWork at officeFlexible hours- ...Operations Lead & Quality Control Manager (Head of Operations & Quality Control) Location: McKinney, Texas (On-Site) Reports To: Chief of Staff... ...KPIs and EOS Rocks. Conduct regular performance reviews and coaching sessions. Ensure alignment between departmental...Contract workTemporary work
- MLK Community Healthcare in Los Angeles, CA seeks a Microbiology Supervisor to lead the Microbiology... ...department, ensuring accurate testing, quality control, and timely reporting. You will... ...testing, and collaborate with the Lab Manager to meet regulatory standards and...
- ...Inc. is seeking a remote- based Clinical Quality Supervisor to oversee clinical quality across... ...practices. You will mentor therapists, review quality metrics, and lead consultations... ...role reports to a Senior Clinical Quality Manager and requires 5+ years of clinical...Remote job
- Villa Healthcare's Villa at Willow Place in Michigan seeks a Nurse Unit Manager RN to oversee daily nursing activities and ensure high-quality care aligned with care plans. The role requires supervising nursing staff, coordinating with admin and therapy teams, and maintaining...Full time
$66.3k - $71.3k
...Quality & Evaluation Director Location: Staten Island, NY Job Type: Full-Time Work... ...objectives. Conduct program chart reviews and prepare detailed findings and recommendations... ...clear reports and presentations for management and leadership. Identify operational...Full timeWork at office- Quality Assurance LeadThe NYC Department of Environmental Protection... ...high-quality drinking water, managing wastewater and storm water,... ...municipal water and wastewater utility in the country, with nearly 6... ...material testing, quality reviews and inspections, standardization...Permanent employmentContract workFor contractorsWork at office
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