utilization review coordinator albuquerque

... works collaboratively with the health care team to ensure proper utilization ... care from the acute setting. The Utilization Management Nurse determines medical ... concurrent and retrospective review of out-patient and in-patient ... and Coordination of Benefits utilization requirements Supports the referrals ... that may result from medical review process (i.e. bed downgrades, change ... Previous experience performing utilization management for Medicare Advantage, ... with Discharge Planning, Medical Review guidelines and/or CMS requirements ... knowledge in medical practices, utilization management processes/standards, ... of experience in utilization management Utilization Review or Case Management ...

Riverside Transport is hiring lease purchase drivers for a dedicated lane! Full walkaway, no down payment, no credit check! Pay: $1.15/mile + FSC + Utilization pay 500 miles per day average guarantee at $.50 CPM. If drivers work 5 days, 2500 miles guaranteed. If drivers work 6 days, 3000 miles guaranteed. At RTI, we give you 2 options to make your truck payment each week! You can pay by the mile ($0.21-$0.26/mile) or a flat rate ($470-$580/week)! Own your own truck in 3-5 years with RTI! Route: Indianapolis to various stores in IN, KY, OH, IL & MO Home Time: Home weekly! This is an early morning/days position. Roughly 10-12 Hour Shifts. Most ...

... follow up procedures. Participates in Quality Improvement projects. Participates in preparing department for internal and external site audits (facility site review) from SCAN, DHS, etc. Participates regularly in site teammate and department meetings. Cross-trains into Care Team Member 1 and 2 positions when indicated. May ... Ability to demonstrate basic medication administration Manual dexterity to use / handle equipment and instruments. Knowledge of infection control standards and utilization of Personal Protection Equipment (PPE). Ability to perform essential job functions using proper body mechanics. Basic Life Support for healthcare providers. ...

Overview: The Education Program Coordinator (PC) administers the Nationwide Childrens Hospital (NCH) Pediatric Cardiology fellowship in ... in MedHub. Prepare and manage fellowship program budgets. Review monthly budget and expense reports and follow-up on ... Maintain education website and training program literature. Review and update at least annually. Work with the GME Office to onboard ... professional organizations as required. Attend monthly Program coordinator, PC Tool, Fellowship and other meetings as a representative of ... of meetings, management of conflicting time demands, and utilization of technology to facilitate participation. Able to hold others ...

... to five years) are determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Qualifications Applicants pending the completion of educational or ... of nurse practitioner students and residents; and ensures that assignments reflect their appropriate utilization, and compliance with staffing guidelines. Participate on service and medical center committees and task ... for highly qualified candidates EDRP Authorized: Contact Hannah Neilson, [Apply online], the EDRP Coordinator for questions/assistance. Learn more. Assignment Code: 75, Nurse Practitioner Permanent Change of Station ...

... professional nursing practice in the clinic setting. The Wound Center Program Coordinator is responsible for the management and the strategic growth of the Wound Care ... revenues generated by the program. Manages costs through appropriate utilization and management of labor and supply across the wound care continuum. Works with ... with the Specialty Clinics Manager and Specialty Clinics Office Coordinator. Ensures that Patient Safety Guidelines are followed, that Wound Center employees ... wound care and HBO protocols as clinically indicated. Complete new patient review form and participate in weekly meetings. Accurately complete the superbill and ensure ...

... Meet regularly with the department chair to review performance matrices. Collaborate with the chair and ... to the faculty. Establish benchmarks for budgetary review. Review analysis of staffing expenses, non-salary expense ... and other members of the Departments support team to review changes in funding, policies and procedures and to ... processes result in accurate allocation of costs; utilization is maximized (within and across departments); ... facilities. Manage space allocations and monitor utilization per departmental and School of Medicine metrics. ... staff, including a department assistant, education coordinator and a grants manager. Assure annual reviews are ...

... IDT member. If a Mental Health Worker revises the care plan other than interventions he/she will collaborate with the primary nurse or the Patient Care Coordinator who will formulate the problem and goal. Reinforces, with patient and family, realistic expected outcomes established in the plan of care. - Provides treatment and care ... control and risk management policies and procedures. · Is knowledgeable regarding managed care implications precertifications and utilization review procedures. · Provides consultation regarding Behavioral Health issues as needed to other hospital staff/departments. Performs other duties as deemed necessary to meet the ...

... supervision of the Director of Utilization Management, the Credentialing and ... and maintenance of all utilization review programs to facilitate the use ... concurrent review timeliness. 5. Compile and report daily review activity and ... Collects and monitors resource utilization data. 12. Actively participates ... any issues related to utilization review processes or delays. 13. ... as requested by the Director of Utilization Management. Credentialing: 1. ... care settings including utilization review, behavioral health and/or ... 4. Working knowledge of utilization review procedures and network ... and understanding of relevant utilization and laws, rules, regulations, and ...

... Business Development responsibilities, and overall organizational efficiencies and workforce utilization. Increase organizations footprint in the region which includes leveraging candidates contact to attract ... procedures to promote and provide a safe work environment Interface with the Testing and Commissioning Coordinator to: assign and schedule work as required to meet project and client requirements, assuring the highest ... appropriate test equipment resources Serve as the Departments contact person with clients and partners Review and approve time sheets and expenses for direct reports Responsible for complete and accurate record keeping ...

... shifts, filling open shifts, and employee messaging. Meets each new employee to review their schedule, ask what needs they have and ensure a smooth onboarding ... coordination and classes. Adheres to scheduling standards, Smartlinx utilization, and best practices. Assists with Fit testing, COVID testing, Biometric ... Maintains ordering and stocking of supplies. Rounds on each shift to provide review of consistent staffing levels WHAT WE'RE LOOKING FOR: Skills in: ... to questions from department and campus employees and leadership team members. Review and analyze report information, while using critical thinking skills to evaluate ...

... characteristics. If you need special accommodation for the application process, please contact Human Resources. Know Your Rights: Responsibilities: The Utilization Review Coordinator is responsible for the assisting with the implementation and ongoing management of the utilization review program for the employee medical benefit program for Prime Healthcare. This position will provide assistance in the direction and utilization of available resources to provide quality, cost effective care using selected benefits and alternative services best suited for the members while ensuring optimal outcomes. This position will work closely with the Prime ...

Overview: Position title: Patient Care Coordinator Salary: $19.00/hour - $40.00/hour (depending on ... Diseases protocol. The Patient Care Coordinator (PCC) will be responsible for all scheduling ... records into the electronic medical record. Review medical records to collect relevant clinical ... pertinent information and forwarding it for review. Refer prospective volunteers per study ... and materials and submission of materials for review. May assist in preparing credentialing ... staff utilization; work with staff in problem solving for overlapping appointments. Review future ... regarding data management project status and review key project questions with clients, working in ...

... rotations as needed. Request additional information for referrals that are incomplete and document requests in the clinical record. Complete clinical record review/audits Manage and document phone calls from physicians, clinicians, patients, referral sources and communicate patient updates/new orders to clinicians. Follow up ... Review clinicians visit notes to ensure timely, complete, appropriate, and accurate submission of documentation by visiting staff. Review, evaluate, and supervise service delivery to ensure appropriateness of care and utilization of services, equipment and supplies through activities such as medical records review and case ...

... in our care. By embarking on a path with our community and ensure Compassion, Acceptance, Respect, Empowerment, and Sincerity with each step we take together. Houston Behavioral Healthcare Hospital (HBHH) currently has an opening for Part-time Utilization Management Coordinator, Monday through Friday (8am-4:30pm). The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients and their families, to serve as a member of interdisciplinary team supporting the organization's treatment program and philosophy, and assure the deliverance of ...

Overview: The Behavioral Health (BH) Case Worker: Service Coordinator will be responsible for providing direct case work/case management services including service eligibility determination, services plan development, service ... issues related to providing services. Responsibilities: The Behavioral Health (BH) Case Worker: Service Coordinator will provide support to people who have an identifiable need within a specific program. Case Worker-Case ... specific positions as needed (e.g. data associated with grants). Respond to Quality Management and Utilization Review protocols and alerts. Ensure that any issues or concerns related to risk (client risk, staff risk, ...

... The Financial Screening Clerk will be responsible for all patients requiring continuous program eligibility review. Will process all new patients and re-evaluate all existing patients for accurate application of eligibility ... patients about the availability and utilization of community and county agencies for financial assistance and make referrals as appropriate. Provides ongoing eligibility review for established patients as stated by the ... Coordinator and Registration Services Coordinator to ensure proper computation of information for billing and management reports. Coordinates in conjunction with Financial Eligibility Coordinator in data input of new ...

... process, please contact Human Resources. Know Your Rights: Responsibilities: The Regional Clinical Care Coordinator is responsible for the development of staff and systems to effectively operate a comprehensive Case ... to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Assesses needs and plans, communicates and designs services that are ... for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process. 5. Experience and knowledge in basic to intermediate computer skills. Preferred qualifications: 1. ...