Healthcare Utilization Review Specialist

Job SummaryWe are seeking a highly skilled Utilization Review Coordinator to join our team at StateJobsNY. As a Utilization Review Coordinator, you will play a critical role in analyzing and evaluating the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.Key...

Job SummaryWe are seeking a highly skilled RN Utilization Review Specialist to join our team at Confident Staff Solutions. As a key member of our Utilization Management team, you will play a critical role in ensuring the efficient use of healthcare resources.Key ResponsibilitiesConduct concurrent reviews of patients' clinical information to identify...

Job SummaryWe are seeking a highly skilled Utilization Review Coordinator to join our team at StateJobsNY. As a Utilization Review Coordinator, you will play a critical role in analyzing and evaluating the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.Key...

Job SummaryWe are seeking a highly skilled Utilization Review Coordinator to join our team at Manhattan Psychiatric Center. As a Utilization Review Coordinator, you will play a critical role in analyzing and evaluating the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.Key...

Job SummaryManhattan Psychiatric Institute is seeking a highly skilled Utilization Review Coordinator to play a critical role in ensuring the delivery of high-quality services to our patients.Key Responsibilities:Review clinical records for completeness and accuracy to ensure compliance with established standards.Collect and analyze data related to the...

Job SummaryWe are seeking a highly skilled Utilization Review Coordinator to join our team at StateJobsNY. As a key member of our healthcare operations team, you will play a critical role in analyzing and evaluating the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.Key...

Job SummaryWe are seeking a highly skilled Utilization Review Coordinator to join our team at StateJobsNY. As a key member of our healthcare operations team, you will play a critical role in analyzing and evaluating the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.Key...

Job SummaryWe are seeking a highly skilled Utilization Review Coordinator to join our team at StateJobsNY. As a key member of our healthcare operations team, you will be responsible for analyzing and evaluating the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.Key...

Job SummaryPlanet Healthcare is seeking a skilled Travel Nurse RN to fill a Utilization Review position in a dynamic healthcare setting.Key ResponsibilitiesConduct thorough reviews of patient cases to ensure optimal healthcare utilizationCollaborate with healthcare teams to develop and implement effective care plansAnalyze data to identify trends and areas...

## Job OverviewWe are seeking a dedicated Utilization Review Nurse to join our healthcare team. The ideal candidate will be responsible for reviewing medical records to ensure that patients receive necessary care and treatment while optimizing healthcare resources.-*Job Description**Initial and concurrent Status Reviews, MDR's, Denial work.*Requirements**RN...

About the JobVNS Health is seeking a skilled Nurse Care Coordinator to lead interdepartmental quality improvement activities, ensuring optimal patient care and compliance with regulatory requirements.Key ResponsibilitiesConduct Clinical Assessments: Perform medication reconciliations, post-discharge transitions of care assessment, and follow-up post...

Job Description:Summary:This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and...

Job OverviewGeneral Overview:The Healthcare Coordination Specialist at MetaSense Inc. plays a crucial role in facilitating communication among various stakeholders, including healthcare providers, insurance entities, and patients. This position is essential for ensuring that medical services are properly authorized and that all regulatory standards are...

Job OverviewPosition: Healthcare Registration SpecialistLocation: New York, NYContract Duration: 3 Months (Potential for Extension)Compensation: $20 - $22 per hourKey Responsibilities:The Healthcare Registration Specialist will be responsible for:Facilitating patient registration processes efficiently.Utilizing the EMR system, specifically EPIC, to manage...

Job Title: HEDIS Review Nurse SpecialistJob Summary:Pride Health is seeking a highly skilled HEDIS Review Nurse Specialist to join our team. As a HEDIS Review Nurse Specialist, you will be responsible for maintaining up-to-date knowledge of HEDIS, QARR, and Star specifications, as well as proficiency in MS Office applications, scanning, and accurate data...

Position Overview:Jobility Talent Solutions is in search of an Insurance Receivable Specialist I to join our Physician & Hospital Billing Insurance teams. This role involves the review, analysis, follow-up, and resolution of insurance balances on designated accounts. The specialist will utilize various methods including insurance websites, phone...

Flexible work arrangement available. Prior experience in Risk Adjustment is MANDATORY. Overview:This role is responsible for meticulously examining, interpreting, auditing, coding, and evaluating medical record documentation to ensure diagnosis precision, proper documentation, and Hierarchical Coding Condition (HCC) abstraction. The review process may...

Job OverviewPosition Summary: The Healthcare Administrative Support Specialist is responsible for performing essential clerical tasks that ensure the smooth operation of healthcare services.Key Responsibilities:Conduct clerical duties such as filing, data entry, and managing reception tasks.Coordinate schedules and meetings, ensuring effective communication...

Vacancy OverviewCompany BackgroundEntity Crédit Agricole Corporate and Investment Bank (Crédit Agricole CIB) is a leading player in the corporate and investment banking sector, part of the Crédit Agricole Group, one of the largest banking groups globally by balance sheet size. With a workforce of approximately 8,600 professionals across more than 30...

Position Overview Title: Healthcare Support SpecialistEmployment Duration: Temporary with potential for extensionWork Environment: Clinical SettingShift Details: 8-hour shifts, 5 days a week, including rotating weekendsRole Summary: As a vital member of the healthcare team, the Healthcare Support Specialist plays a crucial role in delivering patient-centered...