RN Utilization Review, - Louisville

The Utilization Review RN performs activities which support the Utilization Management functions, · The employee communicates with physician and case managers regarding payor approval/denial of admission and continues stay review. · They process payor denials and retro reviews, p ...

The Utilization Review RN performs activities which support the Utilization Management functions. · Promotes optimal management of clinical resources by conducting timely admission and concurrent utilization review for all patients of designated medical services; · Certifies medi ...

The Utilization Review RN performs activities which support the Utilization Management functions. They are responsible for delivering the utilization management process including making clinical recommendations regarding medical necessity for admission and continued stay. · Makes ...

The Utilization Review RN performs activities which support the Utilization Management functions at UofL Health. · Makes clinical recommendations regarding medical necessity for admission and continued stay. · Screens patients for client specific guidelines regarding insurance. · ...

The Utilization Review RN performs activities which support the Utilization Management functions. They are responsible for making clinical recommendations regarding medical necessity for admission and continued stay. · ...

The Utilization Review Coordinator performs admission screening for patients in a bed for medical necessity and reviews the appropriateness of setting and utilization. · ...

The Utilization Review RN performs activities which support the Utilization Management functions. · They are responsible for making clinical recommendations regarding medical necessity for admission and continued stay, · screens patients for client specific guidelines regarding i ...

The Director of Utilization Review/Management is responsible for directing and overseeing the Utilization Management Department which includes the implementation of case management scenarios, · Directs and oversees the Utilization Management Department. · Implements case manageme ...

The Director of Utilization Review/Management is responsible for directing and overseeing the Utilization Management Department. · Directing and overseeing the Utilization Management Department. · Implementing case management scenarios. · Consulting with all services to ensure an ...

The Utilization Review RN performs activities which support the Utilization Management functions. They provide clinical recommendations regarding medical necessity for admission and continued stay, screen patients for client-specific guidelines regarding insurance, Medicare and/o ...

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. · ...

+We are currently seeking Board-Certified Plastic Surgeons with an active Louisiana medical license to perform Utilization Reviews on a flexible, remote basis.++Dane Street , a nationally recognized Independent Review Organization (IRO) and leading provider of Utilization Review ...

+5+ years experience working with Accounts Receivable and/or Customer Service. Successful candidate needs to be detail-oriented · organized self-motivated and customer-oriented. · Candidate will utilize communication skills to contact customers via phone and/or email to confirm p ...

The Project Engineer will support planning and execution of electrical infrastructure projects. · Support project estimating and cost tracking · Maintain project documentation and reports · Review drawings and scopes · ...

This is a WOW (Work on Weekends) position for Authorization Management RN at Louisville, US. · ...

Cordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. · ...

Louisville Gas and Electric Company and Kentucky Utilities Company are regulated utilities that serve more than 1.3 million customers. · LG&E serves 334,000 natural gas and 433,000 electric customers in Louisville and 16 surrounding counties. KU serves 569,000 customers in 77 Ken ...

This is a hybrid position requiring on-site presence three days per week at one of our local offices, located in Allentown, PA (Lehigh Valley), Louisville, KY, or Providence, RI. · Full responsibility to model all complexity levels of the five-year business plan and monthly forec ...

Provides support for clinical member services review assessment processes. · Responsible for verifying that services are medically necessary and align with established clinical guidelines insurance policies regulated ensuring members reach desired outcomes through integrated deli ...