Work Schedule: This is an EVERY Saturday and Sunday role Summary: The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial
Summary: The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment. Interfaces with 3rd party payers by providing pertinent,
Utilization Review Supervisor Candidate must have acute care Utilization Review experience. Candidate must live in the DC/Baltimore region. General Summary of Position Supervises the daily activities of the Utilization Review Team. Manages daily assignment ensuring all UM tasks are completed each day.
Do You have the heart to serve others and making a lifelong impact? We need hope-bringers and changemakers — because the work we all do matters. If you’re passionate about making an impact with your time
Utilization Review Specialist (BCBA Licensee) Utilizing key principles of utilization management the Utilization Review Specialist (BCBA Licensee) performs prospective, concurrent, and retrospective reviews to determine authorization, medical necessity, and appropriateness of ABA services. The Utilization Management Specialist leverages clinical expertise in behavior analysis,
Registered Nurse (RN) Utilization Management Join a dynamic healthcare team where your clinical expertise helps ensure members receive the right care at the right time. We are seeking an experienced Registered Nurse (RN) to support our Utilization Management
Utilization Assistant - Acute The Utilization Assistant provides support to all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization review information. Works with insurance providers to obtain coverage for patients. Assists in utilization reviews and
Utilization Management Nurse Specialist Company Description Lumen Solutions Group Inc. is a technology consulting Services company based in Florida. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation
Job Title Job Overview: Pay Range: $36.49hr - $41.49hr Responsibilities Review, research, and analyze professional and institutional claims using clinical judgment and medical policies for accurate adjudication. Conduct high-level research on medical topics and assess impact on
Utilization Management Nurse Full Time - Day shift (Monday-Friday, 8a-5p), hybrid (Work from both office & home. Must be in commutable distance). Position Objective: Conducts concurrent and retrospective chart review for clinical, financial, and resource utilization information. Provides intervention
Utilization Review Specialist Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent and retrospective reviews for authorization, appropriateness of care determination and benefit coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist will analyze clinical information,
Utilization Review Specialist (BCBA Licensee) Utilizing key principles of utilization management the Utilization Review Specialist (BCBA Licensee) performs prospective, concurrent, and retrospective reviews to determine authorization, medical necessity, and appropriateness of ABA services. The Utilization Management Specialist leverages clinical expertise in behavior analysis,
Medical Director Utilization Management Location: Remote Preference EST or nearby Pittsburgh PA, NY, WV Duration: 6+ Months Contract Role with possible extension. Position Overview As part of a physician team, the Medical Director ensures utilization management responsibilities are
Utilization Management Coordinator I Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination, and quality of care. Duration: 03 months (with possible extension) Location: 100% Remote Education Level:
Health Services - Spec, Utilization Management Utilizing key principles of utilization management, the Utilization Review Specialist (BCBA Licensee) performs prospective, concurrent, and retrospective reviews to determine authorization, medical necessity, and appropriateness of ABA services. The Utilization Management Specialist leverages clinical expertise in
Summary All Native Group, a division of Ho Chunk, Incorporated, is seeking an exceptional Senior Microsoft Cloud Engineer to provide advanced engineering, operational, and advisory support for the Congressional Budget Offices (CBO) Microsoft cloud environments, including
SHINE Systems is seeking a qualified Space Auditor to support the FLS Space Management Team with maintaining accurate, current, and relevant facility and occupancy data. The Space Auditor will work directly with Directorate and Office Space
To get the best candidate experience, please consider applying for a maximum of 3 roles within 12 months to ensure you are not duplicating efforts. Job CategorySoftware Engineering Job Details About Salesforce Salesforce is the #1
SC&Hs Risk Practice is seeking a Senior Manager to lead and grow our service line with a strong focus on security-related consulting, including SOC (SSAE 18), ISO/IEC 27001, and ISO/IEC 42001 engagements. The ideal candidate combines
Overview LMI is seeking a skilled Business Financial Manager to support a Customs and Border Protection customer. Successful LMI Business Financial Manager will demonstrate competency in DHS budget process, financial analysis, SAP, project execution, leadership critical