Manager Utilization Review - Somerville

+Job summary · The UMCM will utilize clinical knowledge to analyze, assess, · and render approval decisions,+Review authorization requests for medical services, · including making initial eligibility and coverage determinations, · ...

We believe that high-performing teams drive groundbreaking medical discoveries.The Opportunity Manages a department of utilization review professionals usually consisting of Registered Nurses, Social Workers and other paraprofessional roles. · ...

Manages a department of utilization review professionals usually consisting of Registered Nurses, Social Workers and other paraprofessional roles. Develops and oversees policies and processes for the team and collaborates with other departments to improve the organization's utili ...

Utilization Review RN to join our team to perform prospective, concurrent and retrospective review of inpatient, · outpatient, ambulatory and ancillary services. Skill & CompetenciesExcellent written · and verbal communication skills. · ...

We are seeking a highly motivated Utilization Review RN to join our team. · Review prospective inpatient services. · Analyze retrospective review requests. · ...

Job summary · The primary purpose of the Utilization Review Specialist is to create and manage the flow of revenue for each client through liaison with insurance companies. · QualificationsHigh School Graduate or equivalent. · Post high school training in the medical field, the i ...

Solomon Page is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Everett, Washington. · Specialty: Utilization Review · ...

The Utilization Review Specialist reviews patient care from admission through discharge to ensure medical necessity. · ...

LanceSoft is seeking a travel nurse RN Case Management for a travel nursing job in Everett. · ...

The Utilization Review Specialist reviews each patient's care at regular intervals from admission through discharge by evaluating the medical record and collaborating with members of the interdisciplinary team. · ...

Westborough Behavioral Healthcare Hospital provides psychiatric stabilization and dual diagnosis treatments for Children, Adolescents and Adult populations in both inpatient and outpatient settings. · ...

The Utilization Review Specialist reviews each patient's care at regular intervals from admission through discharge by evaluating the medical record and collaborating with members of the interdisciplinary team.The purpose of this review is to determine medical necessity, appropri ...

We are seeking a detail-oriented Utilization Review Representative to support our outpatient Mental Health programs. · This role ensures timely authorizations accurate clinical documentation ongoing communication with payers. · The ideal candidate will be able to manage initial c ...

We are looking for a Utilization Review Specialist to provide Per Diem coverage at Westborough Behavioral Healthcare Hospital. · The UR Specialist will monitor adherence to the hospital's utilization review plan. · They will perform concurrent reviews for patients and advocate fo ...

Job Summary:Westborough Behavioral Healthcare Hospital is looking for a Utilization Review Specialist to provide Per Diem coverage. · ...

Ready to help us transform healthcare? Bring your true colors to blue. · BCBSMA is seeking a new Dental Utilization Reviewer to join our elite Dental Utilization Management Division · The team includes dentists, dental hygienists, and dental assistants. · ...

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BCBSMA is seeking a new Dental Utilization Reviewer to join our elite Dental Utilization Management Division. · The team includes dentists, dental hygienists, and dental assistants. · ...

The Physical Therapy Utilization Management Reviewer evaluates services for appropriateness and medical necessity. · Evaluate members' clinical status and benefits. · Analyze clinical outcomes and quality of service. · ...

The PT Utilization Management Reviewer is responsible for facilitating care for members who may have complex healthcare needs. · This position is self-directed and works independently to facilitate care using clinical skills · ...