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Director Of Utilization Review Jobs

Director Patient Access And Utilization Review
By Children's Healthcare of Atlanta At , Brookhaven, 30329

Note: If you are CURRENTLY employed at Children's and/or have an active badge or network access, STOP here. Submit your application via Workday using the Career App (Find Jobs). Work Shift Day ...

Utilization Review Director Jobs
By Coastal Behavioral Health At , Savannah, 31406
Challenging and rewarding work environment
Excellent Medical, Dental, Vision and Prescription Drug Plan
401(K) with company match and discounted stock plan
Career development opportunities within UHS and its 300+ Subsidiaries
Medicaid Utilization Review Analyst
By State of Idaho Employment At Greater Idaho Falls, United States
An opportunity for student loan forgiveness (https://studentaid.gov/manage-loans/forgiveness-cancellation/public-service)
an opportunity for student loan forgiveness (https://studentaid.gov/manage-loans/forgiveness-cancellation/public-service)
THIS ANNOUNCEMENT WILL BE OPEN UNTIL FILLED. APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE TO BE CONSIDERED.
Generous vacation and sick leave accrual beginning as soon as you start
11 paid holidays a year
Multiple savings plans, optional 401K, and optional 457
Director Of Utilization Management
By Ethos At Houston, TX, United States
5+ years of utilization management experience.
3+ years of customer service experience.
Healthcare or medical administrative experience preferred.
Strong oral and written communication skills.
Computer knowledge required, including Microsoft Office products.
Provide training and orientation for new staff along with staff of longevity when rules/laws and/or business practices change.
Director Of Utilization Management
By Ethos At St Petersburg, FL, United States
5+ years of utilization management experience.
3+ years of customer service experience.
Healthcare or medical administrative experience preferred.
Strong oral and written communication skills.
Computer knowledge required, including Microsoft Office products.
Provide training and orientation for new staff along with staff of longevity when rules/laws and/or business practices change.
Utilization Review Coord Jobs
By St. Jude Children's Research Hospital At Memphis, TN, United States
Three (3) years related medical experience
Six (6) months experience in a hospital environment required
Experience with InterQual guidelines and Cerner systems preferred
Utilization Review Coord - 0.8 - Days - Bhs - Service Line
By El Camino Health At , Mountain View, Ca $48.87 - $73.31 an hour
Knowledge and experience in managed care.
Advanced communication skills in advocacy, negotiation and conflict resolution; both written and verbal.
Proven critical thinking and problem-solving skills with the ability to organize, analyze and present data.
Demonstrated ability working well with patients/families, physicians, nursing and ancillary staff.
One of the following licenses:
a. Valid California LCSW license
Health Care Utilization Review Coordinator (Hurc Ii) - Continuum Of Care
By University of Illinois At , Chicago, 60607, Il
Five years (60 months) of RN experience.
Current AHA BLS/CPR and other required unit specific certifications
Effective communication skills (oral and written) that facilitate therapeutic relationships between patients, family, and health care providers
Intermediate computer skills with the ability to become proficient in the Electronic Health Record (EHR) with on-the-job training
Excellent attendance, interpersonal skills and work history required.
Facilitates coordination of patient services in assigned patient care unit, or department
Director Of Utilization Management
By Community Health Centers of the Central Coast At , Santa Maria, 93458, Ca $8,500 - $10,332 a month

Wage Range that the Company Expects to Pay:

Utilization Management Director - Remote - State Of Oh
By UnitedHealth Group At , Dublin, 43016, Oh
Experience with running / managing utilization management efforts
Healthcare and utilization management experience at the managed care plan or provider level
Project management or active project participation experience
Experience in quality management and quality improvement as specified in 42 CFR 438.206 through 438.370
Oversee the plan’s implementation and evaluation of utilization management based on a deep understanding utilization management principle and practice
Oversee the day-to-day operational activities of the Utilization Management Program in accordance with state guidelines
Utilization Review S Jobs
By Whiteforce At , Chandler, Az

Employment Information Industry Utilization Rev Job level Salary - Experience - Pay-Type Close-date JOB-ID JB-21072 Location Chandler, AZ ...

Utilization Review Assistant - Remote Opportunity
By Martin's Point Health Care At , Portland, Me
Basic knowledge of medical terminology, current healthcare benefits and managed care insurance plans
Participates in and contributes to Health Management Department meetings and process improvement initiatives.
Associates Degree or equivalent combination of education and experience
2 years of managed care experience including experience in a call center
Manages the authorization review queues including monitoring for timeliness of responses.
Manages fax queues including uploading faxes to the UM authorization system.
Director Of Utilization Management (Rn)-Remote
By Molina Healthcare At , Las Vegas, Nv $88,453 - $172,484 a year
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
This position will be remote, but does require a Nevada RN license*
To all current Molina employees:
Director Of Admission & Utilization Review
By Recovery Centers of America At , Greenville, 29615, Sc
Knowledge of pre-assessment and pre-certification reviews and able to perform appeal reviews.
Ability to work as a member of a management team.
Knowledge and experience of all continuums of care, including admission assessment and continued stay criteria
Ensures compliance with accreditation agency requirements.
Ensures compliance with the state requirements/guidelines.
Knowledge of discharge planning resources.
Associate Director, Global Medical Review
By Karyopharm Therapeutics Inc. At , Remote $125,000 - $216,000 a year
Experience in content management systems required - Veeva Vault
Demonstrates broad knowledge of disease areas, product labelling, and regulatory guidance.
5+ years experience working in a Medical Review role
Previous experience in scientific communications desired
Working knowledge of FDA regulations relevant to drug promotion and dissemination of medical and product information
Excellent verbal and written communication skills
Assistant Medical Director Of Utilization Management
By UCLA Health At , Los Angeles, 90095, Ca $132,900 - $259,500 a year

Description The Assistant Medical Director of Utilization Management is a member of the leadership team of the UCLA Medical group Utilization Management Department. Under the direction of the ...

Social Worker Ii - Ss - Pmc Utilization Review
By Providence Medical Center At , Kansas City, 66112, Ks
Minimum one (1) year hospital or Outpatient experience with emphasis in mental health care.
Master's Degree in Social Work related field OR.
Master's Degree in Marriage and Family Therapy or related field.
Current BCLS (AHA) certificate upon hire and maintain current.
Behavioral Violence Prevention Training within 3 months of hire and maintain current.

Are you looking for an exciting opportunity to lead a team of professionals in the field of Utilization Review? We are looking for a Director of Utilization Review to join our team and help ensure that our organization is providing the highest quality of care to our patients. As the Director of Utilization Review, you will be responsible for overseeing the utilization review process, developing and implementing policies and procedures, and providing guidance and support to the utilization review staff. If you are an experienced leader with a passion for patient care, this is the perfect opportunity for you!

Overview:

The Director of Utilization Review is responsible for overseeing the utilization review process for a healthcare organization. This includes managing the utilization review team, developing and implementing policies and procedures, and ensuring compliance with state and federal regulations. The Director of Utilization Review is also responsible for monitoring utilization trends and making recommendations for improvement.

Detailed Job Description:

The Director of Utilization Review is responsible for overseeing the utilization review process for a healthcare organization. This includes managing the utilization review team, developing and implementing policies and procedures, and ensuring compliance with state and federal regulations. The Director of Utilization Review is also responsible for monitoring utilization trends and making recommendations for improvement. The Director of Utilization Review is responsible for developing and maintaining relationships with providers, payers, and other stakeholders to ensure the effective and efficient utilization of resources. The Director of Utilization Review is also responsible for developing and implementing strategies to improve utilization and cost-effectiveness.

What is Director Of Utilization Review Job Skills Required?

• Knowledge of healthcare regulations, policies, and procedures
• Knowledge of utilization review processes and procedures
• Ability to develop and implement policies and procedures
• Ability to analyze utilization trends and make recommendations for improvement
• Excellent communication and interpersonal skills
• Ability to work independently and as part of a team
• Ability to manage multiple projects and meet deadlines
• Strong problem-solving and decision-making skills

What is Director Of Utilization Review Job Qualifications?

• Bachelor’s degree in healthcare administration, business administration, or a related field
• At least 5 years of experience in utilization review or a related field
• Knowledge of healthcare regulations, policies, and procedures
• Knowledge of utilization review processes and procedures
• Ability to develop and implement policies and procedures
• Ability to analyze utilization trends and make recommendations for improvement

What is Director Of Utilization Review Job Knowledge?

• Knowledge of healthcare regulations, policies, and procedures
• Knowledge of utilization review processes and procedures
• Knowledge of healthcare reimbursement systems
• Knowledge of healthcare quality assurance and performance improvement
• Knowledge of healthcare data analysis and reporting

What is Director Of Utilization Review Job Experience?

• At least 5 years of experience in utilization review or a related field
• Experience in healthcare administration, business administration, or a related field
• Experience in developing and implementing policies and procedures
• Experience in analyzing utilization trends and making recommendations for improvement

What is Director Of Utilization Review Job Responsibilities?

• Manage the utilization review team and ensure compliance with state and federal regulations
• Develop and