Director of Utilization Review - Raleigh

+Job summary · We are seeking a Utilization Review & Revenue Cycle Coordinator who is detail-oriented...++Track and manage authorizations... · ...

We provide inpatient and outpatient programming for those facing mental health and addiction challenges. Our programs offer caring, compassionate treatment for adults (18+). The responsibility of the Utilization Review Director is to ensure the utilization review activities are c ...

Your experience matters. Triangle Springs is a behavioral health hospital located in Raleigh NC that provides inpatient and outpatient programming for those facing mental health and addiction challenges. · ...

The Utilization Review Supervisor will work with a team to break down barriers and ensure quality and timely determinations are delivered to providers and members. · Coordinating and providing care management and care that is timely, effective, efficient, equitable, safe, and mem ...

Triangle Springs is a behavioral health hospital located in Raleigh, NC that provides inpatient and outpatient programming for mental health and addiction challenges.The Director of Utilization Review will ensure the utilization review activities are completed accurately and in a ...

We're seeking a Utilization Review & Revenue Cycle Coordinator who is detail-oriented, · organized and proactive—someone who understands the importance of payer compliance, · authorization management and clean revenue cycle processes in behavioral health and substance use disorde ...

The Utilization Review Nurse will perform prospective and retrospective utilization reviews for members using evidenced-based guidelines. They must have current licensure as a Registered Nurse (RN) with state licensure and proficiency in Microsoft Office. · Perform prospective, c ...

Triangle Springs is a behavioral health hospital located in Raleigh, NC. We provide inpatient and outpatient programming for those facing mental health and addiction challenges. · ...

h2>Job summary · p> The Utilization Review Coordinator initiates pre-certification calls for private insurance and managed Medicare and Medicaid plans and provides concurrent reviews throughout the patient stays./p> ...

We are seeking a licensed Behavioral Health Utilization Review Clinician to support psychiatric case review and authorization determinations. This role is provider-facing and involves evaluating clinical documentation to determine medical necessity across all levels of psychiatri ...

We are seeking Board-Certified General Surgeons with an active Louisiana medical license to conduct independent medical reviews on a flexible, · fully remote basis. · Conduct independent medical reviews · ...

We are seeking Family Medicine or Internal Medicine board certified physicians to review Prior Authorizations for treatments, · DME requests, SNF admissions, medications, · and more.Flexible Independent Contractor Opportunity · Work 20 to 40 Hours Per Week · An active, unrestrict ...

We are currently seeking Board-Certified Plastic Surgeons with an active Louisiana medical license to perform Utilization Reviews on a flexible, remote basis. · ...

The Utility/Permit Coordinator supports highway improvement projects by reviewing permits and coordinating utility relocations. · ...

You will utilize clinical expertise and review insurance appeals, · prospective and retrospective claims. · ...

+ Job summary + · Are you looking to find meaningful work and positively impact the lives of the residents of North Carolina? If your answer is yes, then we want you to join our team at the Utilities Commission and make a difference. · + ResponsibilitiesInvestigate and analyze fi ...

Great facility in Southern California is looking for experienced Case Manager/Utilization review traveler to work 13 week assignments. · ...

The Professional Services Management Unit (PSMU) is looking for a Business Officer I to develop and maintain the program/section to fulfill the duties of the Financial Review Group. · In this role you will:Utilize your significant experience with financial principles and practice ...

The employer is seeking a Medical Director of Utilization Management to work in North Carolina. The job requires experience in clinical practice and utilization management. The ideal candidate should have thorough understanding of current CMS and DNV compliance requirements. · Se ...

The North Carolina Department of Commerce is seeking a Program Coordinator IV to join their team in Wake County. · ...