Utilization review jobs in Jersey City, NJCreate job alerts

Directs all aspects of the program and is responsible for: planning, continued program development, Quality Assurance, performance improvement, utilization review, customer satisfaction, and other projects assigned. Responsible to oversee daily operations of the Involuntary Outpatient Commitment ...

Also responsible for reviewing and taking any corrective action needed for capital budgets in the ... Ensures the proper and effective assignment and utilization of the department's consultant ...

Responsibilities: Preparation: • Review Electronic Medical Records (EMR) and previous assessments to prepare for visits. • Utilize critical thinking and problem-solving skills for case ...

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 ...

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

... 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 ...

Review Patient medical documentation * Setup communication to assist patient enrollment into managed care plans * Performs other duties that may be assigned Qualifications: * New or Previous ...

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 ...

... utilization, billability, grade pyramids etc. * Experience in planning, organizing and tracking Digital Trainings * Experience in creating management review reports. * Experience in Advance MS Excel

Utilize evidence-based strategies to prevent hospitalization and inappropriate ER utilization ... Review and authorize service requests according to workflows and timelines. * Collaborate with ...

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

The position also involves reviewing outcomes, coding, and utilization data to enhance participant health and reduce unnecessary utilization. Benefits * Medical, Vision, Dental, and Life Insurance

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 ...

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

Review and interpret screening and diagnostic observations and report findings to the project ... Familiarity with database utilization, regulatory compliance and human subject's protection issues

Continually adapt warehouse layout to ensure efficient space utilization of Facilities/Building Maintenance * Review and approve all Operational Invoices for payment * Learn and continually re ...

Complies with infection control practices such as hand washing, proper utilization of PPE, etc ... Reviews work que/email of abnormal findings from radiologist. * Make appointment for follow -up ...

Review and process rental applications, ensuring compliance with company policies and local ... Train staff on AppFolio features and ensure proper utilization of the platform. * Provide ongoing ...

... review current work and make regular reports to senior management about how InRhythm teams and ... Optimize utilization and resource planning across the organization by making staffing decisi