ABA Utilization Review - Skokie - Spectrum Billing Solutions

We are looking for motivated, dependable and dedicated caregivers to provide exceptional direct care and support to our patients. The Utilization Review Coordinator is responsible for overseeing the Utilization Review Program. · ...

We are looking for motivated, dependable, and dedicated caregivers to provide exceptional direct care and support to our patients. The Utilization Review Coordinator is responsible for overseeing the Utilization Review Program.This includes the implementation of case management s ...

Provides clinically based case management to support the delivery of effective and patient care under the general supervision of the Manager. Partners with Social Workers and collaborates with other health care team members to identify appropriate utilization of resources. · ...

We are looking for a Utilization Review Specialist to join our team The Utilization Review Specialist bridges between a Utilization Review Nurse and Pre-Clinical Coordinator providing coverage for both teams. · Initiate and maintain appropriate verbal and/or written contacts with ...

This position is responsible for ensuring compliance of the Utilization Management (UM) and Quality Review (QR) functions performed by the Medical Groups/IPAs participating in the networks of client's HMOs. · ...

This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity. · ...

Provides clinically based case management to support delivery of effective patient care. · ...

The Utilization Review (UR) Coordinator is responsible for contacting external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient's stay as well as assists the treatment team in understanding the insurance c ...

+Job summary · Lensa does not hire directly for these jobs but promotes them on behalf of its direct clients. · +Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. · Evaluates documentation/information to de ...

We are looking for a Utilization Review Specialist to join our team The Utilization Review Specialist bridges between a Utilization Review Nurse and Pre-Clinical Coordinator providing coverage for both teams. · The full UR function can be performed in applicable jurisdictions. UR ...

This position is responsible for ensuring compliance of the Utilization Management (UM) and Quality Review (QR) functions performed by the Medical Groups/IPAs participating in the networks of client's HMOs. · 3 years clinical experience with 2 years' experience in utilization rev ...

This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members on the telephone reviewing medical records reviewing cases which involve contract interpretation of behavioral health diagnos ...

The Utilization Review (UR) Coordinator is responsible for contacting external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient's stay. · Degree in nursing, social work, mental health/behavioral sciences, ...

+The Medical Director is responsible for the overall quality, effectiveness and coordination of medical review services. · +Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies. · Renderecoverage determinations. · ...

+ Utilization Review Specialists bridge between a Utilization Review Nurse and Pre-Clinical Coordinator + Facilitate and schedule appointments as needed + Maintain appropriate electronic and paper files + Interface with inter-disciplinary providers + Basic invoicing at completion ...

The Utilization Review (UR) Coordinator is responsible for contacting external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient's stay as well as assists the treatment team in understanding the insurance c ...

This position performs medical review of claims suspended for medical necessity using medically accepted criteria. · Candidates must reside in TX or IL · ...

Coordinate and perform all aspects of Worker's Compensation, auto, and general liability claims for medical management activity (IME/Peer Review, UR) to ensure optimum medical care service delivery. · ...

Be part of a world-class academic healthcare system as a RN Manager in the Rev Cycle Department. · ...

This position involves utilizing clinical knowledge and communication skills to obtain patient-specific information regarding patient condition and proposed treatments and procedures. The role requires certification of treatment for confinement when certain criteria are met. · Co ...

+ Job summary: Utilization Review Registered Nurse position available at Hines & Associates with competitive salary and benefits. Work-life balance and remote/hybrid setting (once trained). · + Qualifications: RN license, recent acute clinical practice required. · + Responsibilit ...