Utilization Review Jobs in Orange
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Search Results - Utilization Review Jobs in Orange
Nesco Resource, LLC-Orange
period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review. Maintains professional client relationships.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties...
resume-library.com -
MedPro Healthcare Staffing-Orange
or veteran status.
Key Words: RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN
• Weekly payment estimates are intended for informational purposes only...
Impresiv Health-Orange
behavioral health providers. The incumbent is responsible for utilization management, quality reviews and monitoring activities of BHT services. The incumbent will directly interact with providers for care coordination for BHT/ABA services.
What You Will Do...
resume-library.com -
Orange
and evaluates services provided. Performs the appropriate utilization review functions utilizing medical staff-approved decision support criteria (InterQual Intensity of Service, Severity of Illness criteria). Concurrently intervenes to enhance patient quality...
uci.edu -
Equiliem-Orange
from behavioral health providers. They are also responsible for utilization management, quality reviews and monitoring activities of BHT services. The Care Manager will directly interact with providers for care coordination for BHT/ABA services.
Duties...
resume-library.com -
Orange
as required by the Utilization Review department.
• Conduct weekly audit of medical records to ensure quality and timely submission of clinical documentation and coordination of treatment planning. Address deficiencies when identified.
• Intervene and assist...
icims.com -
Orange
Must demonstrate customer service skills appropriate to the job
• Minimum 5 years of clinical experience
• Minimum 2 years of clinical experience working on a specialty unit (Med Surg, any ICU, ED, Mental Health)
• Familiarity with Utilization Review...
uci.edu -
Discovery Behavioral Health DBH-Irvine, 6 mi from Orange
Job Description
The Utilization Review Case Manager requires effective communication and coordination with the Director of Utilization Review, insurance companies, and treatment team to obtain the maximum benefits for our clients.
The Utilization...
resume-library.com -
Marvel Consultants-Los Angeles, 27 mi from Orange
a team of 20+, case managers and social workers.
• Licensed RN with the BSN, Masters preferred.
• 5+ years hospital discharge planning, utilization review, case management and social work experience, with management experience.
• RN-BC Certification...
mindmatch.ai -
Macpower Digital Assets Edge Private Limited (MDA Edge)-Los Angeles, 27 mi from Orange
Health Plan guidelines and patient needs.
Assures compliance with Federal, State, TJC, NCQA, other regulatory agencies and internal standards and requirements.
Provides direction to staff regarding utilization review, care coordination, discharge...
resume-library.com -
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