Physician Utilization Review Specialist Per Diem HUMC
3 days ago
We are seeking a highly skilled Physician Utilization Review Specialist to join our team at Hackensack Meridian Health. As a key member of our healthcare team, you will play a critical role in ensuring the integrity of clinical records and promoting high-quality patient care.
Key Responsibilities- Regulatory Compliance
- Provide direction and support regarding CMS & NJDOH regulations governing Utilization Management & Clinical documentation.
- Oversight for accurate patient status determinations - OBS vs. Inpatient.
- Liaison to the Medical Staff supporting Utilization Management Committee processes.
- Hospital Based Appeals Management.
- Provides guidance and interpretation on issues of medical appropriateness and level of care needs.
- Liaison between Medical Staff and Other Clinical Staff
- Excellent communicator.
- Broad spectrum clinical knowledge base.
- Expert resource related to admission criteria, observation status criteria and documentation requirements.
- Education/Advisory
- Physician Educator.
- Provide formal educational lectures and engage in frequent informal meetings.
- Retrospective Medical Record Documentation Review.
- Clarifying ambiguous or conflicting documentation.
- Target DRGs Reviews.
- Use of case manager as a resource.
- Utilization Review Process
- Subject Matter Expert in the use & application of Utilization Management Criteria (i.e. MCG).
- Supports & Participates in pre-admission review, utilization management, and concurrent and retrospective review process.
- Review and facilitate appropriate Level of Care Determinations (Inpatient, Observation, Outpatient/Ambulatory).
- Conducts and/or supports improvement and outcomes studies related to Utilization Management (Self-Audits & other auditing activities).
- Electronic Health Record (EHR)/Other Technology
- Partners with Operations and Senior Leadership to assess and implement technology.
- Collaborates with the CDI team as needed.
- Medical degree from a recognized Medical School.
- Completion of a residency program from an accredited medical institution.
- Minimum of 3 years medical practice experience.
- Ability to effectively communicate with professional peers, department members and all levels of administration.
- Medical Doctor License.
- Maintains at least one Medical Board Certification.
-
Hackensack, New Jersey, United States Hackensack Meridian Health Full timeJob SummaryWe are seeking a highly skilled Clinical Utilization Management Specialist to join our team at Hackensack Meridian Health. As a key member of our healthcare team, you will play a critical role in ensuring the integrity of clinical records and promoting high-quality patient care.Key ResponsibilitiesRegulatory ComplianceProvide guidance and support...
-
Hackensack, New Jersey, United States Hackensack Meridian Health Full timeOverview The Senior Physician Specialist in Utilization Review plays a pivotal role in collaborating with the healthcare team to ensure the accuracy and integrity of clinical documentation for patients within the Hackensack Meridian Health network. This position encompasses a variety of responsibilities including utilization review, hospital reimbursement,...
-
Hackensack, New Jersey, United States Hackensack Meridian Health Full timePosition Overview The Senior Physician Specialist in Utilization Review plays a crucial role in collaborating with the healthcare team to ensure the accuracy and integrity of clinical documentation for the patient population at Hackensack Meridian Health. This position encompasses various responsibilities, including utilization review, hospital...
-
Hackensack, New Jersey, United States Hackensack Meridian Health Full timeOverview The Senior Physician Specialist in Utilization Review collaborates with the healthcare team to oversee and resolve activities that ensure the accuracy of clinical documentation for the patient population and Hackensack Meridian Health. Responsibilities encompass utilization review, hospital reimbursement, clinical compliance, case management, and...
-
Hackensack, New Jersey, United States Hackensack Meridian Health Full timeHackensack Meridian _Health_ is seeking a Board Certified, fellowship trained Chief of Breast Surgery for the Hackensack University Medical Center. This position is an outstanding leadership opportunity located in a very desirable area of New Jersey with excellent schools and easy access to New York City. The successful candidate will have significant...
-
Hackensack, New Jersey, United States Hackensack Meridian Health Full timeJob Summary Hackensack Meridian Health is seeking a highly skilled Physician Assistant to join our Neonatology Department in a Per Diem capacity. As a key member of our team, you will provide exceptional patient care and contribute to the delivery of high-quality services in our Level III-IV NICU.ResponsibilitiesLeadershipParticipate in decisions affecting...
-
Physician Collaboration Specialist
1 week ago
Hackensack, New Jersey, United States Your Wellness Care Full timeJob Title: Physician Collaboration SpecialistWe are seeking a highly skilled Physician Collaboration Specialist to join our team at Your Wellness Care. As a key member of our medical team, you will be responsible for providing high-quality chart review and examinations remotely.Responsibilities:Conduct virtual/tele-medicine conferences for patient clearance...
-
Per Diem Care Manager
3 days ago
Hackensack, New Jersey, United States The Senior Company Full timeThe Senior Company is seeking a licensed social worker to join our Mint Care Management Program as a Per Diem Care Manager. This role offers flexibility and autonomy, allowing you to work as much or as little as you like.Requirements:Must be a licensed social worker in New JerseyMust be able to drivePay Rate: $50 per hourResponsibilities:Client Care:Review...
-
Utilization Management Care Coordinator, RN
1 week ago
Hackensack, New Jersey, United States Hackensack Meridian Health Full timeOverview At Hackensack Meridian Health, our team members are essential to our mission of enhancing patient care and promoting healthier lives. We foster a culture of collaboration and connection, ensuring that our employees thrive in a supportive environment. Our commitment to competitive benefits is just the beginning; we prioritize mutual support and...
-
Per Diem Care Manager
4 days ago
Hackensack, New Jersey, United States The Senior Company Full timeThe Senior Company is seeking a licensed social worker with experience in senior care to join our Mint Care Management Program as a Per Diem Care Manager. This flexible position allows you to work on your own schedule, choosing the hours that suit you best.Requirements:Must be a licensed social worker in New JerseyMust be able to driveCompensation:$50 per...
-
Healthcare Utilization Management Coordinator
2 weeks ago
Hackensack, New Jersey, United States Hackensack Meridian Health Full timeOverviewAt Hackensack Meridian Health, our team members are essential to our mission of enhancing patient care and fostering a supportive environment. We are dedicated to helping our patients lead healthier lives while also empowering our staff to thrive. Our culture emphasizes collaboration and connection, ensuring that we not only provide competitive...
-
Utilization Management Care Coordinator, RN
2 weeks ago
Hackensack, New Jersey, United States Hackensack Meridian Health Full timeOverview At Hackensack Meridian Health, our workforce is integral to our mission of enhancing patient health and well-being. We prioritize a culture of collaboration and connection, ensuring that our employees thrive while delivering exceptional care to our community. The Utilization Management Care Coordinator plays a vital role within the healthcare team,...
-
CT Imaging Specialist
2 weeks ago
Hackensack, New Jersey, United States Hackensack Meridian Health - 30 Prospect Avenue Full timePosition OverviewThe CT Imaging Specialist is responsible for performing advanced computer tomography procedures and related techniques, producing both sectional and three-dimensional images for diagnostic interpretation. This role also involves assisting with interventional and therapeutic procedures.Key ResponsibilitiesComplex CT Procedures: Execute...
-
Travel Nurse Oncology Specialist
3 days ago
Hackensack, New Jersey, United States Health Advocates Network-Nursing Full timeJob Title: Travel Nurse Oncology SpecialistWe are seeking a highly skilled Travel Nurse Oncology Specialist to join our team at Health Advocates Network-Nursing. As a Travel Nurse Oncology Specialist, you will have the opportunity to work with a variety of patients and healthcare professionals, providing top-notch care and making a meaningful impact in the...
-
Travel Nurse RN
1 week ago
Hackensack, New Jersey, United States Firstat Medical Staffing Full timeJob Title: Travel Nurse RN - NICU SpecialistJob Summary:Firstat Medical Staffing is seeking a skilled Travel Nurse RN to join our team as a NICU Specialist. As a Travel Nurse RN, you will have the opportunity to work in a dynamic and challenging environment, providing high-quality patient care and contributing to the success of our healthcare...
-
Travel Nurse RN
1 week ago
Hackensack, New Jersey, United States Firstat Medical Staffing Full timeJob Title: Travel Nurse RN - NICU SpecialistJob Summary:Firstat Medical Staffing is seeking a skilled Travel Nurse RN to join our team as a NICU Specialist. As a Travel Nurse RN, you will have the opportunity to work in a dynamic and challenging environment, providing high-quality patient care and contributing to the success of our healthcare...
-
Travel Nurse RN NICU Specialist
27 minutes ago
Hackensack, New Jersey, United States Health Advocates Network-Nursing Full timeJob OverviewHealth Advocates Network-Nursing is seeking a skilled Travel Nurse RN NICU Specialist to join our team.Key ResponsibilitiesProvide high-quality patient care in the Neonatal Intensive Care Unit (NICU)Collaborate with healthcare professionals to develop and implement individualized care plansConduct thorough assessments and evaluations to identify...
-
Hackensack, New Jersey, United States PRN Healthcare Full timeAbout the JobPRN Healthcare is seeking a skilled Catheterization Laboratory Specialist to join our team on a per diem basis. As a Cath Lab Technologist, you will be responsible for assisting in the performance of diagnostic and interventional procedures in a hospital setting.Key ResponsibilitiesAssist in the preparation and maintenance of the cath lab,...
-
Travel Nurse RN Specialist
5 hours ago
Hackensack, New Jersey, United States Health Advocates Network-Nursing Full timeJob Title: Travel Nurse RN SpecialistWe are seeking a highly skilled Travel Nurse RN Specialist to join our team at Health Advocates Network-Nursing. As a Travel Nurse RN Specialist, you will have the opportunity to work in a dynamic and challenging environment, providing exceptional care to patients in the NICU unit.Job Summary:Provide high-quality patient...
-
Flexible Care Management Specialist
1 week ago
Hackensack, New Jersey, United States The Senior Company Full timePosition Overview:The Senior Company is seeking experienced Licensed Social Workers to support our Mint Care Management Program, focusing on the needs of seniors.Work Arrangement:This is a Per Diem role, allowing you to choose your availability and work schedule according to your preferences.Essential Qualifications:- Must hold a valid social work license in...