Utilization Reviewer - Tampa, FL

Company Description · CASE HEALTH AI (CHAI) specializes in creating AI-driven solutions that automate administrative tasks for health plans, with a focus on prior authorizations. Our advanced AI tools analyze faxes, clinical documents, and guidelines to deliver accurate, explaina ...

Company Description · CASE HEALTH AI (CHAI) specializes in creating AI-driven solutions that automate administrative tasks for health plans, with a focus on prior authorizations. Our advanced AI tools analyze faxes, clinical documents, and guidelines to deliver accurate, explaina ...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partne ...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partne ...

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. · ...

· Company Description · Why You Should Work For Us: · HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positi ...

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. · 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. · Validates the patient's placement to be at the most appropriate level of care based on nationally accepted admissio ...

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 ...

· Company Description · Why You Should Work For Us: · HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positi ...

GQR Healthcare is seeking a travel nurse RN Utilization Review for a travel nursing job in Baltimore, Maryland. · Job Description & Requirements · Specialty: · Utilization Review · Discipline: · RN · Duration: · 13 weeks · 40 hours per week · Shift: · 8 hours, days · Employment T ...

Job Description · The QA Engineer is responsible for ensuring timely development, review, and approval of engineering, validation, and lifecycle documentation in alignment with corporate procedures, SOPs, cGMP, and industry best practices. This role supports manufacturing, engine ...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partne ...

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 ...

The Physician Advisor will drive quality performance across the organization by communicating with hospital physicians, utilization management, case management, CDI, the denials team, and quality staff. The Physician Advisor conducts case reviews to ensure compliance, appropriate ...

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 ...

The case manager coordinates the care and service of selected patient populations across the continuum of care; promote effective utilization and monitoring of health care resources. · Discharge planning for inpatients. · Utilization Review for inpatients · ...

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 ...

We are the world's trusted infrastructure consulting firm, partnering with clients to solve the world's most complex challenges and build legacies for future generations. · ...