Utilization Reviewer - Hialeah, FL, US

The Utilization Nurse is responsible for conducting prospective, concurrent, and retrospective clinical reviews to determine medical necessity... · ...

The Utilization Review Analyst supports the Florida PACE Centers' UM Program by combining administrative expertise with analytical skills to optimize healthcare resource use.This role ensures efficient workflows, compliance, · and real-time oversight while collaborating with inte ...

Lensa is a career site that helps job seekers find great jobs in the US and promotes jobs on LinkedIn for its direct clients. · Accesses and assigns cases for utilization review (UR). · ...

The Utilization Review Analyst supports the Florida PACE Centers' UM Program by combining administrative expertise with analytical skills to optimize healthcare resource use. · Coordinates and schedules UM-related meetings and communications with interdisciplinary teams and hospi ...

The Utilization Nurse is responsible for conducting prospective concurrent and retrospective clinical reviews to determine medical necessity level of care and appropriateness of services across the continuum · This role collaborates closely with hospital UR/Case Management facili ...

The Clinical Resource Coordinator acts as a resource to all levels of staff in defining / implementing and evaluating patient care and nursing practice standards utilizing clinical expertise, · Leads the assessment, planning, implementation, and evaluation for new department mode ...

As a Utilization Review Specialist, you will play a pivotal role in ensuring the efficient and effective utilization of healthcare resources. · ...

We are seeking a Utilization Review Specialist to join our team. The successful candidate will be responsible for reviewing and evaluating clinical documentation, treatment plans, and medical records to optimize patient care and streamline healthcare delivery processes. · ...

We are seeking an experienced Utilization Review (UR) Specialist to join our team at Mental Health Treatment Centers of America in Fort Lauderdale, FL. · Review Client admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. ...

As a Utilization Review Specialist, you will play a pivotal role in ensuring the efficient and effective utilization of healthcare resources. · ...

+We seek an experienced Utilization Review (UR) Specialist to join our team to review client admission and clinical information, obtain initial and continuing authorization for treatment services, interact with insurance companies and document all necessary information. · +Review ...

· Company Description · 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 positions with some of the largest a ...

· Company Description · 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 positions with some of the largest a ...

The Vice President of Utilization Review is responsible for overseeing the strategic direction and operational efficiency of revenue cycle management (RCM) functions, heavily focused on Out of Network (OON) with growing focus on In-Network (INN) and Medicaid. · Collaborates with ...

The Clinical Resource Coordinator is a professional member of the health care team who has 24hour/7day accountability for the coordination, monitoring and management of patient care resources to promote cost effective delivery of patient care services at the appropriate level whi ...

This Utilization Review Registered Nurse position at Mount Sinai Medical Center involves coordinating participant care and ensuring timely discharges. Responsibilities include monitoring service utilization, working with providers to ensure appropriate medical care levels for par ...

The Vice President of Utilization Review is responsible for overseeing the strategic direction and operational efficiency of revenue cycle management (RCM) functions. · ...

**Vice President of Utilization Review - Exact Billing Solutions (EBS)  · Lauderdale Lakes, FL - In Office - No Remote** · Salary Range: $200K - $230K · This is a full-time, on-site role requiring daily presence at our Lauderdale Lakes, FL location. · Who We Are · Exact Billing S ...

· Company Description · 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 positions with some of the largest a ...

The Vice President of Utilization Review is responsible for overseeing the strategic direction and operational efficiency of revenue cycle management (RCM) functions, heavily focused on Out of Network (OON) with growing focus on In-Network (INN) and Medicaid. · ...