utilization review coordinator illinois

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... LPN/LVN) to join our team. The Clinical Quality Assurance Coordinator is responsible for ensuring Peer Review case reports are of the highest quality and integrity and in ... be our next new team member! Responsibilities: Performs quality assurance review of peer review reports, correspondences, addendums or supplemental reviews. Ensures ... have been followed and that all questions have been addressed. Ensures each review is supported by clinical citations and references when applicable and verifies ... and procedures and client specifications. Promote effective and efficient utilization of company resources. Participate in various educational and or training ...

... opportunity? ExamWorks is seeking a Clinical Quality Assurance Coordinator to join our team! This position is 100% remote and the schedule ... 4:30pm CT. The Clinical Quality Assurance Coordinator is responsible for ensuring Peer Review case reports are of the highest quality and ... member! . Responsibilities: Performs quality assurance review of peer review reports, correspondences, addendums or supplemental ... followed and that all questions have been addressed. Ensures each review is supported by clinical citations and references when applicable ... and client specifications. Promote effective and efficient utilization of company resources. Participate in various educational and or ...

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 ...

... in clinic service revenue, employee productivity and adjust clinic hours and operations as determined by utilization metrics. Utilize Customer Relationship Management software to market to, and engage with return clients, ... in the roll-out of policies and procedures and/or education materials; participate in the development, review, revision, training, and monitoring of the implementation of facility processes. In conjunction with the ... creating an inclusive environment for all team members. At this time, if you will be working in California, Illinois, New Mexico, Oregon, Rhode Island, New York, Washington or Canada, vaccination against COVID-19 is required ...

... 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 ...

Overview: The Utilization Management Nurse is responsible for following ... Performs initial and concurrent review on inpatient, skilled nursing ... per Milliman Care Guidelines, Utilization Management Department Policies, ... initiatives developed for the Utilization Management Department. Report ... audits Run reports, as needed, to review and analyze client data (i.e. Days/K, ... ALOS). Act as a resource for Utilization Management staff, providers, ... projects. Attend monthly client Utilization Management Committee meeting(s) as ... Utilization Management statistics and discuss cases, at the Utilization ... of experience in concurrent Utilization Review in a Health Plan or hospital ...

... 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 ...

... technical and clinical information and communicates results of monitoring activities to patients, nurses and physicians as required regarding the contents, utilization, therapeutic actions, possible adverse reactions or interactions of drugs. Initiates, reviews and updates all AristaCare required documentation per Policy and ... computer order-entry, labeling and dispensing. Participates with nurses and physicians in all clinical activities as requited, including start of care prospective review of medical and drug histories, pharmacokinetic dosing, dosage monitoring for compromised patients, reviewing laboratory test results, attending patient care ...

... techniques to obtain optimal data. Reviews cases with the radiologist when appropriate. Reviews labs and patient history to perform correct exam. Responsible to review radiology orders for completeness and accuracy. Reviews patient history and supporting clinical data for medical necessity. Takes steps to acquire additional ... immediately including those that are a near miss. Assists in instruction of students and new staff as necessary. May perform duties of Sono Lead or Imaging Coordinator in his/her absence. Meets productivity levels as established by department benchmarking. Assists other areas during downtimes so to maintain productivity. May ...

... 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 ...