Utilization Review Jobs in Maryland
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Search Results - Utilization Review Jobs in Maryland
Ageatia Global Solutions-Baltimore
JOB Title: Utilization Management Specialist- Hiring Now!!! 3+ Roles to be filled IMMEDIATELY!!!
Job Description
Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent...
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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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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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iCallidus-Bethesda (MD)
iCallidus is seeking a LPN Utilization Management Nurse Reviewer (Referral Management Review). This individual will participate in direct, referral management review activities within the Integrated Referral Management and Appointing Center (IRMAC...
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University of Maryland Medical System-Baltimore
for coverage; reviews hospital charges for accuracy, makes adjustments for duplicated or incorrect billing, as appropriate; calculates and determines level of patient benefit and enters appropriate proration into PMAS; forwards bill to third party payers...
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MEDSTAR HEALTH-Baltimore
Experience
• 5-7 years Diverse clinical experience required and
• 3-4 years For utilization management (UM), 3 years UM concurrent review experience; for case management (cm), 3 years CM experience required and
• Leadership experience preferred
Licenses...
1 similar job: Annapolis
Managed Care Advisors-Bethesda (MD)
Bachelor's degree in business, or a related field, education may be substituted with experience, including two (2) or more years of experience in workers' compensation, claims administration, and/or utilization review.
• Three (3) years of administrative...
MEDSTAR HEALTH-Baltimore
Experience
• 5-7 years Diverse clinical experience required and
• 3-4 years For utilization management (UM), 3 years UM concurrent review experience; for case management (cm), 3 years CM experience required and
• Leadership experience preferred
Licenses...
1 similar job: Annapolis
Generis Tek Inc.-Salisbury (MD)
requirements.
Participation in required meetings including but not limited to: patient care conferences, utilization review meetings, rehabilitation meetings, etc.
Participate in facility and company required trainings, in-services and conferences.
Able...
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Association of Clinicians for the Underserved-Baltimore
and mentoring by identifying deficits and needs for physician leadership training and opportunity.
• Provides leadership to management within areas of responsibility, to include but not limited to; Quality and Safety, Utilization Review, Medical Staff governance...
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1 similar job: Chicago
Total Care Services, Inc.-Lanham (MD)
internal program integrity audits pursuant to Dept. of Healthcare Finance (DHCF) indicators and HR-5 False Claims Act Policy.
• Perform programs utilization reviews based on anomalies in services identified through reports, data, personnel action, and ISP...
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Managed Care Advisors-Annapolis
Bachelors degree in business, or a related field, education may be substituted with experience, including two (2) or more years of experience in workers compensation, claims administration, and/or utilization review. Three (3) years of administrative...
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1 similar job: Baltimore
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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Fidelity Partners-Bethesda (MD)
economy and efficiency.
Prepare materials for incorporation into workflow and operational analyses, cost studies and/or equipment utilization.
Review and update policy; fix broken links; address system issues; take suggestions from administrative staff...
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Highmark Health-Baltimore
that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity...
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1 similar job: Annapolis
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