- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: This Utilization Review Denials Review Unit (DRU) 3 Team Lead will assist the Director of Utilization Review and the Associate Director ... five years RN nursing experience required. Minimum of 1 year of denial management experience with progressive proficiency and autonomy of reviews AND a minimum of… more
- Kaleida Health (Buffalo, NY)
- …and tactics to successfully execute, support, implement, and monitor the DRG and Utilization Management Clinical Denial teams Work Plan and, assists in the ... 72111BR **Department:** 24068 - Clinical Revenue Cycle Admin **Job Description:** The Director , Clinical & DRG Denials provides clinical leadership and… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical ... individual and Company performance. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/172723/corporate- director -of-clinical- utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare… more
- Billings Clinic (Billings, MT)
- …leadership and Physician Advisor, per department process or procedure Insurance and Utilization Management Maintains working knowledge of CMS requirements and ... - 44.18 Under the direction of department leadership, the Utilization Review/ Management RN. This position is...to Case Manager on current outliers, potential outliers, and denials Identifies reviews that need to be completed on… more
- Trinity Health (Silver Spring, MD)
- …closely related area. + Extensive knowledge of payer mechanisms and clinical utilization management is required. + Knowledge of pertinent regulatory, ... **Employment Type:** Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review, under the supervision and in… more
- Sharp HealthCare (San Diego, CA)
- …competency and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge planning, as ... as Allscripts.Identify opportunities for cost reduction and participate in appropriate utilization management venues.Escalate and refers cases for consultation… more
- Brockton Hospital (Brockton, MA)
- PURPOSE OF POSITION: The Director of Case Management is responsible for planning, directing, and managing of the activities of the Case Management Program ... solves problems, referring exceptional issues to Vice President. The Director of Case Management is responsible for...enhances the quality of patient care while optimizing resource utilization . Provides training to staff on case management… more
- Providence (Mission Hills, CA)
- … program in the Southern California Region. The Manager assists the Regional Director of Utilization Management , Appeals & Clinical Training through ... **Description** The Manager of Utilization Management provides a key role...lieu of acute care + Previous experience working with denials and appeals in/for an acute care setting +… more
- BronxCare Health System (Bronx, NY)
- Overview Assists in the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care ... and implementation of educational programs for Denial Prevention and Management . Responsibilities - Establish and maintain positive relationships with patients,… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …third party payers and communicate potential or identified concerns to the treatment team, Director of Utilization Management , and the Medical Director . ... transform healthcare and serve as a leader of positive change. The Utilization Management Coordinator utilizes clinical knowledge and understanding of behavioral… more