Case Manager Utilization Review - Tampa, FL

We are seeking an experienced LPN to join our team as a Utilization Reviewer. The ideal candidate will have a minimum of 2 years of varied clinical experience and proficiency in MS Office with basic computer and typing skills. · ...

Your Experience MattersAt TGH Behavioral Hospital we are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others.Joining our team you're embracing a vital mission dedicated to making communities healthier.Join us on this meaning ...

We are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. · ...

We are proud to be one of the largest employers in the Tampa Bay area. · Functions as the primary liaison between the funding agents and all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient obser ...

Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary hospital admissions. Follow established procedures and processes to complete authorizations. · ...

The Utilization Review Director is responsible for ensuring the utilization review activities are completed accurately and timely. This includes precertification and recertification, peer-to-peer process, and appeals. · ...

We are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals... · Functions as the primary liaison between funding agents and related parties. · Perform other duties assigned by supervisor including processing concurr ...

You will be held responsible for the comprehensive review of the medical information for the assigned medical record review and completion of all paperwork, communication and data entry involved. · ...

The Director of Utilization Review ensures that utilization review activities are completed accurately and timely at TGH Behavioral Hospital. · ...

The Utilization Review Case Manager validates the patient's placement to be at the most appropriate level of care based on nationally accepted admission criteria. · The UR Case Manager secures authorization for the patient's clinical services through timely collaboration and comm ...

The Utilization Review Case Manager validates the patient's placement to be at the most appropriate level of care based on nationally accepted admission criteria. · The UR Case Manager uses medical necessity screening tools, · to complete initial and continued stay reviews in det ...

The Utilization Review Case Manager validates the patient's placement to be at the most appropriate level of care based on nationally accepted admission criteria. · ...

We are currently seeking a dedicated Utilization Reviewer to join our dynamic team. · ...

Utilization Review/Outpatient Care RN · Are you an experienced Registered Nurse with Utilization Review experience looking for a new opportunity with a prestigious healthcare company? · Review medical information in order to determine medical necessity of services requestedDeterm ...

Assists Case Managers in achieving goals through removing accounts from Do Not Bill work queue and discharge planning. · ...

Assists Case Managers and Social Workers in achieving the goals of the Case Management department through successful completion of removing accounts from Do Not Bill work queue and discharge planning including payer communication certification and authorization timely delivery do ...

The Utilization Review Team Lead will direct and coordinate the daily operations of the UM department responsible for concurrent reviews and observation management. · ...

Ambulatory nurse case manager coordinates patient care across the continuum of care; · promotes effective utilization and monitoring of healthcare resources; · maintains knowledge base of payer information for team collaboration; · and assumes a leadership role with the interdisc ...

Job summaryThe Case Management Extender is responsible for providing administrative and clerical support to the Case Management Director and Case Management Team including assisting with audits, reports, and data collection. · QualificationsHigh School Diploma or GEDBasic Life Su ...

The Education Coordination position at BayCare involves collaborating with the Utilization Review Leadership team to develop educational tools for hospital-based teams. Key responsibilities include developing onboarding programs, conducting training sessions, and reporting areas ...