FEATURED JOBS
Showing 40-50 of 2095
…to the appropriate next level of care. + Has working knowledge of utilization management functions and performs these duties as assigned; monitors patient acuity to
…works with physicians, clinic support staff, case managers, nurses, insurance utilization management staff, and patients to initiate pre-authorization and resolve
…the patient that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist as necessary to
…formulary and prescription benefits. + Generate reports relating to rebates, physician utilization , Beers Criteria, Reliance members, and other ad hoc reports. +
…patient care. + Resource Management + + Identifies opportunities to improve utilization of resources. + Professional Development + + Takes responsibility for meeting
…knowledge by participation in continuing education, reading journals, resource utilization , vendor resources, and attending any required courses as observed
…therapy treatment and evaluation principles, techniques, and materials and equipment utilization . + Must demonstrate knowledge of state and federal accreditation.
…+ Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. + Submits
…Reviews and analyzes section activities and data to improve operations, and utilization of services. + Assures compliance with standards set forth by accrediting
…using established protocols + Validates financial responsibility prior to service utilization and completes an accurate financial interview at time of registration