Healthcare Utilization Review Coordinator

Job SummaryThe RN Utilization Review Specialist is a key member of the healthcare team at Christus Health, responsible for ensuring the clinical appropriateness of care provided to patients and optimizing hospital resource utilization. This role involves performing pre-admission, concurrent, and retrospective reviews to ensure that patients receive the most...

Job Summary:The RN Utilization Review Specialist is responsible for ensuring the clinical appropriateness of care provided to patients and optimizing hospital resource utilization. This role involves performing pre-admission, concurrent, and retrospective reviews to ensure compliance with regulatory requirements and industry standards. The RN Utilization...

Position Overview: The Registered Nurse - Utilization Review Specialist plays a crucial role in assessing the clinical necessity of patient care and optimizing the use of hospital resources. Key Responsibilities: Utilize established screening criteria such as InterQual, MCG, and CMS Inpatient List to evaluate patient care.Manage a varied workload effectively...

Job Title: Registered Nurse - Utilization Review and Case Management at Christus HealthJob Summary:The Registered Nurse - Utilization Review and Case Management is responsible for ensuring the clinical appropriateness of care provided to patients and optimizing hospital resource utilization. This RN will perform a variety of pre-admission, concurrent, and...

About the RoleAveanna Healthcare LLC is seeking a highly skilled and organized Client Services Supervisor to join our team. As a Client Services Supervisor, you will play a critical role in coordinating staffing needs, managing schedules, and fostering positive relationships with patients, families, and caregivers.Key ResponsibilitiesCoordinate staffing...

Are you driven by a desire to make a meaningful impact in healthcare? At OptumCare, we believe that transforming lives begins with the values we uphold and the dedication we exhibit in our roles. The Clinical Operations Coordinator plays a crucial role in supporting the Utilization Management (UM) department by overseeing various administrative tasks related...

Position Overview This role is essential in bridging the gap between various stakeholders, including the community, healthcare providers, external specialists, social service professionals, and network collaborators. Key Responsibilities Facilitate communication and coordination among community members and healthcare systems. Enhance the...

Job Overview*** NOT A REMOTE POSITION ***Texas Home Medical is seeking a dedicated Healthcare Billing Coordinator to enhance our billing department. Our organization specializes in durable medical equipment, including CPAP, BIPAP, oxygen systems, and related supplies. The ideal candidate should exhibit a strong willingness to learn and adapt to new...

Job SummaryWe are seeking a highly skilled CLS Provider Utilization Coordinator Specialist to join our team at QTC Management, Inc. This role will be responsible for coordinating with clinic office managers and business partner agencies to maximize clinic capacity.Key ResponsibilitiesCommunication and Coordination: Consistently and effectively communicate...

Job Summary:Russell Tobin & Associates is seeking a skilled Healthcare Intake Coordinator to join our team in San Antonio, TX. As a liaison between customers, healthcare providers, and third-party payers, this role is responsible for securing necessary documentation for shipping and claims billing.Key Responsibilities:Analyze and prioritize orders based on...

Job OverviewAre you dedicated to enhancing the lives of children with unique healthcare requirements? As a Case Coordinator, you will be instrumental in delivering comprehensive, individualized case management services. Your responsibilities will encompass the complete case management cycle, from initial assessment to the creation and execution of...

Nitelines USA, Inc is actively looking for a skilled individual to fill the role of Healthcare Administration Faculty Coordinator.Requires a Bachelor's Degree in a relevant discipline.At least 3 years of experience in healthcare management.Expertise in Microsoft Visio, Access, SharePoint, Project, and the standard Office Suite.Knowledge of Adobe Acrobat Pro...

Position Overview:The role of the Referral Coordination Specialist is pivotal in managing the comprehensive referral process within a busy healthcare environment. This includes tasks such as securing orders from physicians, obtaining necessary insurance authorizations, scheduling patient appointments with participating physicians, and informing patients...

Location:On-SiteCompany:AEG VisionAbout the Role: The Patient Care Coordinator plays a vital role in delivering outstanding service by warmly welcoming patients and ensuring the seamless execution of all check-in and checkout procedures.Key Responsibilities: - Greet patients, clients, and visitors with a friendly demeanor as they enter the facility. -...

Overview:The Healthcare Access Coordinator plays a crucial role in ensuring a seamless entry point for patients into our healthcare system. This position is dedicated to establishing encounters for patients while adhering to the highest standards of customer service. The Coordinator is responsible for maintaining precise data entry, including demographic and...

About the RoleAt Elara Caring, we are committed to delivering exceptional care to our patients and their families. As a Client Care Coordinator, you will play a vital role in shaping the future of healthcare by providing support to our team of compassionate and dedicated healthcare providers.Key ResponsibilitiesCollaborate with Healthcare Providers: Work...

Overview:The Senior Utilization Management Nurse plays a crucial role in assessing the clinical necessity of patient care and optimizing the use of hospital resources. This position involves conducting various pre-admission, concurrent, and retrospective reviews related to utilization management. The nurse is expected to proficiently apply established...

Overview:The Healthcare Access Coordinator plays a vital role in ensuring a seamless and welcoming experience for patients at our facilities. This position is essential for establishing patient encounters that align with our commitment to outstanding customer service. The Coordinator is responsible for accurate data entry, which includes capturing...

Job Title: Concurrent Review Nurse - RNJob Summary:We are seeking a skilled Concurrent Review Nurse - RN to join our team at Pyramid Consulting, Inc. As a key member of our healthcare industry client, you will be responsible for managing facilities for acute care in patient stays, conducting initial reviews, concurrent stay reviews, and discharges. This is a...

Position OverviewWe are seeking a dedicated MDS Coordinator to join our compassionate team at Sunrise Nursing & Rehab Center. The ideal candidate will play a crucial role in ensuring the delivery of high-quality care to our residents.Key ResponsibilitiesThe MDS Coordinator will be tasked with:Completing the federally mandated Minimum Data Set (MDS) in...