Utilization Review Coordinator

Job SummaryNew York State Psychiatric Institute is seeking a Utilization Review Coordinator to analyze and evaluate the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.Candidates from outside or within State Service can apply for this position under the Hiring for Emergency...

Dane Street is seeking a Physician to provide utilization review services for the Group Health Department.This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical appropriateness of services in compliance with state regulations, nationally recognized evidence-based guidelines, and client-specific...

Dane Street, a certified "Great Place to Work" company, is seeking a Physician to provide utilization review services for the Group Health Department.This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical appropriateness of services in compliance with state regulations, nationally recognized...

Job Title: Drug Utilization Review SpecialistAt destinationone Consulting, we are seeking a highly skilled Drug Utilization Review Specialist to join our team. As a key member of our healthcare recruitment team, you will play a crucial role in evaluating medication use patterns to promote safe and effective medication therapy.Key Responsibilities:Conduct...

Drug Utilization Review SpecialistAt destinationone Consulting, we are seeking a highly skilled Drug Utilization Review Specialist to join our team. As a key member of our healthcare recruitment team, you will play a crucial role in evaluating medication use patterns to promote safe and effective medication therapy, ensuring optimal patient outcomes.Key...

Job OpportunityMomentum Resource Solutions is seeking a highly skilled Medical Director to join our team.Job SummaryThe Medical Director will play a crucial role in ensuring appropriate healthcare utilization management. As a physician and policy advisor, you will work closely with our Chief Medical Officer to develop and implement policies that promote...

Job Title: Travel Nurse RN Utilization ReviewTalent4Health is seeking a skilled Registered Nurse (RN) for a travel nursing job in a dynamic healthcare setting.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNEmployment Type: TravelKey Responsibilities:Conduct thorough utilization reviews to ensure optimal patient care and resource...

Job SummaryNYC Health Hospitals is seeking a skilled Medical Review Coordinator to join our team. As a Medical Review Coordinator, you will play a critical role in ensuring the quality and efficiency of our healthcare services. Key Responsibilities1. Conduct thorough medical reviews to ensure accurate and timely documentation in patient records. 2....

NYC Health + Hospitals/Metropolitan is a community hospital of choice for residents of East Harlem, northern Manhattan, and neighboring communities.The hospital provides culturally-sensitive care in a welcoming and hospitable setting, emphasizing primary care medicine and utilizing the latest advances in medical science.Metropolitan delivers high-quality...

Job Title: Clinical ReviewerJob Description:We are seeking a skilled Clinical Reviewer to join our team at Greenlife Healthcare Staffing. As a Clinical Reviewer, you will be responsible for conducting utilization reviews up to and including the appeal level. This includes chart screen, completing electronic worksheets, entering the required information, and...

Job Title: Utilities ManagerA&E Properties II Mgmt LLC is seeking a highly skilled Utilities Manager to join our team. The successful candidate will be responsible for managing all utility accounts, ensuring accuracy and efficiency in our operations.Key Responsibilities:Coordinate with the India Accounts Payable Team and assigned utility representatives to...

Job SummaryWe are seeking a highly experienced and skilled Director of Utilization and Denials Management to join our team at WellSpan Health. As a key member of our leadership team, you will be responsible for overseeing the operations of the utilization management department and working closely with hospital, regional, medical group, Population Health,...

Job OpportunityGreenlife Healthcare Staffing is seeking a skilled Maternal Nurse Reviewer to join their team.Key Responsibilities:Conduct thorough reviews of medical records and other relevant documents.Conduct interviews and observations to ensure comprehensive program monitoring.Develop and draft reports to meet departmental requirements.Track document and...

Clinical Reviewer Job DescriptionAs a Clinical Reviewer at IPRO, you will play a critical role in ensuring the accuracy and appropriateness of medical reviews. Your expertise will be utilized to conduct thorough clinical level reviews, supporting Medical Review Analysts and Physician Consultants in their decision-making processes.Key Responsibilities:Conduct...

Medical Review SpecialistWe are seeking a highly skilled Medical Review Specialist to join our team at Concentra. As a Medical Review Specialist, you will be responsible for reviewing medical files and providing recommendations for utilization review, chart reviews, medical necessity, and appropriateness of care.Key Responsibilities:Reviews medical files and...

Job Title: Maternal Nurse Reviewer Contract Metropolitan Area Job Description: Greenlife Healthcare Staffing is seeking a Maternal Nurse Reviewer to fill an opening with a Non-profit organization located in New York. Responsibilities: * Conduct clinical reviews of medical records from a variety of sources as well as other documents crucial to the...

Job Title: Workers Compensation Nurse Case ReviewerAbout the Role:Brighton Health Plan Solutions (BHPS) provides Utilization Review/Medical and Case Management services for Group Health and Workers' Compensation and other Casualty clients. The Workers Compensation Nurse Case Reviewer collaborates with medical care providers, employers, employees, and at...

Job Title: Care ManagerJob Specialty: Utilization Management and Care CoordinationJob Duration: 9 monthsShift: Hybrid 9-5Guaranteed Hours: 40 hours per weekResponsibilities:- Provide care management and coordination services to patients and families.- Conduct utilization reviews and plan discharges to ensure optimal patient outcomes.- Collaborate with...

Job SummaryWe are seeking a skilled and experienced physician to join our medical review team as an independent contractor. As a Medical Review Specialist, you will be responsible for reviewing health claims and providing medical interpretation and decisions about the appropriateness of services provided by other healthcare...

Job SummaryWe are seeking a highly skilled Utilization Manager to join our team at LESC. The successful candidate will be responsible for ensuring compliance with external and internal utilization review/quality and appropriateness requirements, working collaboratively with CASAC Counselors and supervisory staff as needed.Key ResponsibilitiesCollaborate with...