Search Results: 33,773 vacancies
...Responsibilities:
Responsible for the quality and resource management of all patients that are admitted to the facility from the point... ...perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service...
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...Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Glendale, California.
Job Description & Requirements
~ Specialty: Utilization Review
~ Discipline: RN
~ Duration: 13 weeks
~40 hours per week
~ Shift...
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Immediate need for a talented Supervisor - Case Manager/Utilization Review . This is a 03+ Months Contract opportunity with long-term potential and is located in Los Angeles, CA(Onsite) . Please review the job description below and contact me ASAP if you are interested...
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Job Description: Manager of Clinical Utilization Management - Denial Compliance
Location: Burbank, CA
Position Type: Hybrid (85% remote, 15%... ...licensed denial unit staff, managing daily tasks, performance reviews, and any necessary disciplinary actions.
2. Foster...
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$47.31 - $88 per hour
...The RN Float Case Manager and Utilization Review Nurse provides coverage for an RN Case Manager or RN Utilization Review Nurse. The RN Float Case Manager and Utilization Review Nurse is assigned to function in the role of either a RN Case Manager or RN Utilization Review...
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Full time
...for associated medical groups.
Key Responsibilities:
1. Supervise licensed and non-licensed denial unit staff, managing daily tasks, performance reviews, and disciplinary actions.
2. Collaborate effectively with physician reviewers, medical directors, and other...
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...Responsibilities
Utilization Review (UR) Coordinator Opportunity.
Position: PRN (as needed)
This position is on-site and cannot... ...before applying, please contact Loretta Gaspar , HR Manager at: ****@*****.***
What do our current employees...
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...moving forward.
Job Overview
Under the direction of the Director, Medical Management this position is responsible for overseeing and managing the day-to-day operations of the Utilization Management Department, health plan delegated activities, and medical...
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...Description
Job Title: Director, Utilization Management
Department: Health Services - UM
About the Role:
Leads and shapes the Utilization... ...functions, including prior authorizations, concurrent review, medical claims review, and appeals and grievances. Directs...
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...of network and appropriateness of treatment setting reviews within scope of licensure by utilizing appropriate medical policies and clinical guidelines... ...quality, cost effective care throughout the medical management process.
Educates the member about plan benefits and...
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...POSITION SUMMARY:
This position is responsible for the management of the daily operations of Utilization Management (UM) at APLA Health and Wellness (APLAHW).... ...tools and evidence-based criteria for utilization review.
Develop, implement and maintain compliance,...
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.... You can do all this and more at UCLA Health.
As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team... ...Pre-service Authorizations/Denial Letters
* Concurrent Review
* Continuity of Care
* Retro Claims
*...
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Monday to Friday
...plays a critical role in our participant's journey and our Utilization Management team ensures we can provide timely, quality, compliant, and... ...operations within the designated UM team
Assist the team in reviewing prior-authorization requests for medical necessity and...
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...Job Summary:
Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and... ...Provides direction to staff regarding utilization review, care coordination, discharge planning, and other services...
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...Job Description
Under the supervision of Regional Director of Care Management, the Utilization Management Coordinator is responsible for providing support to the Care Management team who coordinates care. This position works closely as a healthcare team member and performs...
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...Therapy Providers for 2023", and to us being labeled as a certified "Best Place To Work"!
What would this role do?
As a Utilization Management Coordinator, you report to the Supervisor of Utilization Management and partner closely with the Care Navigation & Intake...
Hourly pay
Local area
Monday to Friday
...position is responsible for providing support to the Medical Management department to ensure timeliness of outpatient or inpatient referral... .../health care specialty call center.
Prefer experience in utilization management processing authorization referrals.
Salary...
Hourly pay
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...I. Job Purpose and Core Tasks
The Manager, Customer Success Utilization plays a critical role in: 1) managing overall customer satisfaction of installations 2) driving effective customer utilization of specific technology products post go live., within their respective...
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.... It's the calling of our lives and it compels us to keep moving forward.
Job Overview
The LVN Utilization Management Nurse (UM Nurse) will provide routine review of authorization requests from all lines of business using respective national/state, health plan, nationally...
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Flexible hours
...into tomorrow. Provides overall project management involving Data Collection Unit's (DCU's)... ...clients (various municipalities and other utility companies in obtaining construction... ...needed for all compliance/quality/integrity reviews. Develops project plans, scope of work,...
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3 days per week
