Utilization Review Jobs in Maryland
1 - 15 of 18
Search Results - Utilization Review Jobs in Maryland
JobGet Staffing-Columbia (MD)
requiring utilization review approval were reviewed and processed in accordance with utilization review decisions, - Deductibles, coinsurance and other appropriate cost-sharing features of the benefit plan were considered and correctly applied, - The claim...
University of Maryland Medical System-Largo (MD)
General Summary
Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patient’s need for outpatient or inpatient...
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Nicolle Gonzales-Germantown (MD)
supervisory experience required. Experience in the development and management of quality, risk, and utilization review processes. Demonstrated leadership, communication, and analytical skills. Able to use computers. Reads, writes, speaks and comprehends...
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ICONMA, LLC-Baltimore
Our Client, a Health Insurance Company, is looking for Utilization Management Specialist for their Baltimore, MD/Hybrid location
Responsibilities:
Utilizing key principles of utilization management, the Utilization Review Specialist will perform...
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CenterWell Home Health-Annapolis
documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed.
• Analyzes situations, identifies problems, identifies and evaluates alternative...
Lumen Solutions Group, Inc.-Baltimore
management, the Utilization Review Specialist will perform prospective, concurrent and retrospective reviews for authorization, appropriateness of care determination and benefit coverage. Leveraging clinical expertise and critical thinking skills...
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Nicolle Gonzales-Silver Spring (MD)
supervisory experience required. Experience in the development and management of quality, risk, and utilization review processes. Demonstrated leadership, communication, and analytical skills. Able to use computers. Reads, writes, speaks and comprehends...
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Charlestown by Erickson Senior Living-Catonsville
clinical quality areas including wound care, infection control, falls risk reduction, pain management, weight loss, and dehydration.
Participating in Wound Rounds, Operations Meetings, Utilization Review, and Performance Improvement/Risk Management/Safety...
mindmatch.ai -
2 similar jobs: Glen Mills, Novi
Sigma Inc-Gambrills
role into
contributing to facility patient care, utilization review, case management, administrative staff/department head, and family conference activities and communications.
Establishing and maintaining a good working relationship with other...
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Erickson Living-Catonsville
Monitoring clinical quality areas including wound care, infection control, falls risk reduction, pain management, weight loss, and dehydration.
• Participating in Wound Rounds, Operations Meetings, Utilization Review, and Performance Improvement/Risk...
mindmatch.ai -
Nesco Resource, LLC-Bethesda (MD)
with utilization review (UR) nurses to identify the most appropriate treatment based on industry standards and Program-related conditions. In this process, you will use our proprietary claims processing system containing clinical edits.
Remote Bill Processor...
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MedChi, The Maryland State Medical Society-Kensington (MD)
The selected provider will also have experience in the development and management of quality, risk, and utilization review processes with demonstrated leadership, communication, and analytical skills. Spanish speaking is strongly preferred, but not required...
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Clinton (MD)
regarding Case management members.
• Collaboration with Community Support Programs.
• Utilization Review for Designated Hospitalized members.
• Phone Coverage for urgent line and member services lines.
• Treatment Record Reviews.
• Provide members...
icims.com -
Franciscan Missionaries of Our Lady Health System Inc-Baltimore
requirements, space requirements, utilization review, quality assurance, marketing, etc.
5. Demonstrates competency and accuracy in all work tasks, including those directly and indirectly related to patient care.
6. Inspires confidence from patients, visitors...
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1 similar job: Annapolis
Ampcus Incorporated-Baltimore
s): Baltimore, MD
Job Description:
PURPOSE:
Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality...
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