The Utilization Review Specialist, under supervision and in collaboration with the Utilization Review Coordinator, Utilization Review Nurses, Physician advisor and healthcare team supports all administrative tasks/responsibilities for utilization management and revenue integrity cycle processes. Interacts directly and indirectly with internal and external providers to review and monitor members' utilization of health care services with the goal of maintaining high-quality cost-effective care. The URS works collaboratively with utilization management staff to obtain information from clinical reviews and medical records to provide the appropriate communication for authorization of medical services and procedures. The URS is an integral member of the health care team as well as the integrated care team and supports the case management/utilization review team on system-wide quality improvement/performance improvement initiatives. Perform other duties as needed and assigned by your supervisor. REQUIRED EDUCATION AND EXPERIENCE:
Lawrence General Hospital is a private, non-profit community hospital providing the Merrimack Valley & southern New Hampshire regions with patient-centered, compassionate, and quality health care for the whole family. For over 140 years, the dedicated doctors, nurses, and staff of Lawrence General have been committed to improving the health of the people and communities we serve.
We are an Equal Opportunity Employer committed to hiring a diverse workforce.
Location: Lawrence General Hospital · Integrated Care Schedule: 40 hours, Days, Days...Job Title: ED Technician Location: Monmouth Medical Center Department Name: Emergency Department Req #: 0000213876 Status: Hourly Shift: Evening Pay Range: $20.57 - $25.81 per hour Pay Transparency: The above reflects the anticipated hourly wage...
...workshops, and seminar series. # Participates in teaching of statistics topics within graduate programs. # Supervises the work of Biostatisticians I, II, III and Analyst/Programmers serving on the same projects. # Performs other related duties incidental to the work...
...rapidly expanding and we need great people to join our team.The Physician Reviewer is the primary physician reviewer for Utilization Management/... ...'s lives every single day.Current Employee apply HERE (Current Contingent Worker please see job aid HERE to apply\#LI-Remote
...experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity.... ...career as a Patient Logistics Coordinator RN Psych with Research Psychiatric Center.... ..., hospitals, emergency rooms (ERs), urgent care centers, outpatient centers, physician...
...About the Role We are seeking a Security Analyst to join our Security Operations team. This role is ideal for someone with prior cybersecurity experience who is ready to take ownership of monitoring, analyzing, and responding to security events in a dynamic MSP environment...