Utilization review jobs in Hackensack, NJCreate job alerts

Description We're looking for a PET/CT Nuclear Medicine Technologist , working in Healthcare Systems and Services industry in Hackensack, New Jersey, United States . Job Summary: Under the direction of the Manager/In-Charge Technologist and Medical Director the nuclear medicine tec...

Supports & Participates in pre-admission review, utilization management, and concurrent and retrospective review process. The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records for...

Minimum Qualifications NYC Children's Center is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and efficiency of psychiatric and medical services ...

Job Summary: • Review and evaluate the assessment and UAS information for members in the MLTC and MAP lines of business. • Develop a working relationship with the PCP to be able to contact and ...

Position Summary Performs concurrent utilization review activities on all patients within the assigned caseload. Collaborates and educates the medical staff on appropriate utilization review ...

Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using standardized criteria to achieve optimal patient outcomes and ...

Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift, night shift, and mid shift Job types available: full time, part time, and per diem Employer features: 401(K) ...

Develop, implement and evaluate case management programs, including utilization review, and discharge planning. * Establish and maintain relationships with community-based services and organizations ...

Coordinate with Utilization Management (UM) department on concurrent and retrospective review. Follow up with assigned nurses for clinical updates to care plan. Document within two business day ...

A minimum of two years experience performing utilization review, claims adjudication, medical review, fraud investigation, surveillance or monitoring activities, required; OR * Three years of ...

... utilization review plan for the Residence; monitors compliance and reports regularly to the Regional Director on the status of compliance efforts. • Reports all untoward incidents and directs ...

... review, etc., following established MetroPlusHealth Utilization Management policies, procedures, and protocols. - Oversee the coordination and delivery of comprehensive, quality healthcare and ...

... on proper utilization of those medical devices. * Supervise procedures for students taking ... Review and maintain accurate and current health records in accordance with local governmental ...

Participate with materials management in the review and selection of all specialty supplies, dressings, and materials for wound and ostomy care to facilitate cost-effective utilization and compliance ...

... tool utilization, build quality, and customer specific requirements. • Based on site review and analysis, identify Supplier performance areas in need of improvement, provide feedback on site ...

Assess appropriate site of care utilization and continued medical necessity reviews for prior authorization to vendors. * Ensure communication with MD offices in relation to Site of Care program

... to ensure optimal utilization of services. * Ensure quality standards set by the external ... Provide ongoing review of emergency equipment, biological and medications in order to maintain ...

Participates in helping to review and develop medical guidelines and policies geared toward quality ... Previous Utilization Management Experience in Acute Care Setting * Prior leadership experience ...

... Review, engage, plan and deploy necessary security governance process' and practices so that ... utilization of Cybersecurity resources, · Drive strategy for security awareness management · ...

Reviews, evaluates, and supervises service delivery to ensure appropriateness of care and utilization of services, equipment, and supplies through activities such as random patient visits, medical ...

... for the Utilization of Paralegal Services. ESSENTIAL DUTIES AND RESPONSIBILITIES* * Drafts ... Review due diligence documentation. * Prepare title and survey comments and coordinate with title ...

... and utilization of referral services, as part of the health care system. Assists in providing ... Reviews and analyzes trends pertinent to delivery of nursing care services and collaborates with ...

Review and ensure effective development and execution of personalized care plans that result in ... the utilization of services and implements changes and adjustments to meet needs and goals

... team utilization, advising on full-time and freelance staffing needs. * Coordinate freelance ... Review and proof proposals for accuracy and alignment with standards. Administrative & General ...