- Kelsey-Seybold Clinic (Pearland, TX)
- …requests for medical and surgical procedures, services and admissions . The Utilization Review Specialist communicates with providers regarding pertinent ... **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews, benefit verification, and applying criteria to… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the ... Management Criteria ( ie MCG ) b. Supports & Participates in pre- admission review , utilization management, and concurrent and retrospective review … more
- Spectrum Billing Solutions (Skokie, IL)
- …Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management ... to work 100% fully remote . Your Responsibilities: + Review patient admission and clinical information to... | UR Specialist | Revenue Cycle Utilization Review Specialist | ABA… more
- HonorHealth (Scottsdale, AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** ** Utilization Review Admission Specialist (OR Scheduler), Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** ... The Utilization Review Specialist coordinates scheduling of all surgical/endoscopic hospital admissions , pre- admission testing and operating room… more
- ProMedica Health System (Toledo, OH)
- The Payor Specialist is responsible for payor notification, and securing authorizations for all admissions systemwide. They receive and answer voicemail and ... UM department. Completes timely initial notification of all inpatient and observation admissions systemwide with per payor contract via phone, fax, and payer portals… more
- Carle (Urbana, IL)
- …each applicable transfer, completes documentation per hospital guidelines.* Performs admission Utilization review on all direct admissions & transfers to ... RN- Clinical Admission Specialist + Department: Transfer Coordination...Apply Now Position Summary: Facilitates and coordinates all direct admissions , interhospital transfers as well as transfers in accordance… more
- Fairview Health Services (St. Paul, MN)
- …implementation, and reporting of complex clinical data. The utilization management specialist is responsible for the completion of admissions and continued ... and appropriate based on payer requirements. The utilization management specialist concurrently monitors the appropriateness of admission and continued stay… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will...in any inpatient setting. Performs telephonic and/or on site admission and concurrent review , and collaborates with… more
- Johns Hopkins University (Baltimore, MD)
- …effective recruitment strategies. + Utilization of AAMC and campus admission /enrollment reporting tools to collect and analyze admissions statistics ... Assists significantly with the file evaluation and interviews of applicants for admission . Participate during admissions committee meetings to discuss applicant… more