Sentences with phrase «in utilization review»

I have also done investigation for healthcare fraud and have experience in utilization review.

Not exact matches

For the past 12 years, Zintro expert John Daller, MD, PhD, FACS has led Daller Consulting, specializing in the areas of medical - legal review, due diligence and scientific evaluations, and utilization review.

Dr. Rapier is a pioneer in managing Medicare risk business, understands the role of comprehensive drug utilization review and adherence in improving the healthcare quality and cost outcomes.

This research stream, which is primarily conducted within ARS's National Program on Quality and Utilization of Agricultural Products, is reviewed / renewed in five - year cycles, with the next cycle starting in 2015.

Luke Rudmik, M.D., M.Sc., of the University of Calgary, Canada, and colleagues evaluated the utilization patterns of topical intranasal steroid therapy for CRS in the Canadian population with a review of a Canadian population - based health care administrative database.

In the related studies presented at the annual meeting, «Trends in Total Hip Arthroplasty in the United States: The Shift to a Younger Demographic» and «Trends in Total Knee Arthroplasty in the United States: Understanding the Shift to a Younger Demographic,» researchers conducted a retrospective review of 2000 - 2009 hospital discharge data on TKR and THR patients from the Nationwide Inpatient Sample (NIS) Healthcare Cost and Utilization Project (HCUPIn the related studies presented at the annual meeting, «Trends in Total Hip Arthroplasty in the United States: The Shift to a Younger Demographic» and «Trends in Total Knee Arthroplasty in the United States: Understanding the Shift to a Younger Demographic,» researchers conducted a retrospective review of 2000 - 2009 hospital discharge data on TKR and THR patients from the Nationwide Inpatient Sample (NIS) Healthcare Cost and Utilization Project (HCUPin Total Hip Arthroplasty in the United States: The Shift to a Younger Demographic» and «Trends in Total Knee Arthroplasty in the United States: Understanding the Shift to a Younger Demographic,» researchers conducted a retrospective review of 2000 - 2009 hospital discharge data on TKR and THR patients from the Nationwide Inpatient Sample (NIS) Healthcare Cost and Utilization Project (HCUPin the United States: The Shift to a Younger Demographic» and «Trends in Total Knee Arthroplasty in the United States: Understanding the Shift to a Younger Demographic,» researchers conducted a retrospective review of 2000 - 2009 hospital discharge data on TKR and THR patients from the Nationwide Inpatient Sample (NIS) Healthcare Cost and Utilization Project (HCUPin Total Knee Arthroplasty in the United States: Understanding the Shift to a Younger Demographic,» researchers conducted a retrospective review of 2000 - 2009 hospital discharge data on TKR and THR patients from the Nationwide Inpatient Sample (NIS) Healthcare Cost and Utilization Project (HCUPin the United States: Understanding the Shift to a Younger Demographic,» researchers conducted a retrospective review of 2000 - 2009 hospital discharge data on TKR and THR patients from the Nationwide Inpatient Sample (NIS) Healthcare Cost and Utilization Project (HCUP).

In a 2003 research review, Nancy Roizen of the Cleveland Clinic and David Patterson of the University of Denver focused on a particular gene that is crucial to energy production and oxygen utilization inside cells.

Charles H. Hennekens, M.D., Dr.P.H., the first Sir Richard Doll professor and senior academic advisor to the dean in the Charles E. Schmidt College of Medicine at Florida Atlantic University published a review for clinicians on the optimal utilization of aspirin to treat and prevent heart attacks.

In general, the review found that increases in out - of - pocket costs seemed to have a lower impact on reducing utilization for specialty drugs as compared to the effects reported for non-specialty drugs, probably because specialty drugs often have no medically comparable alternatives, Doshi and her coauthors notIn general, the review found that increases in out - of - pocket costs seemed to have a lower impact on reducing utilization for specialty drugs as compared to the effects reported for non-specialty drugs, probably because specialty drugs often have no medically comparable alternatives, Doshi and her coauthors notin out - of - pocket costs seemed to have a lower impact on reducing utilization for specialty drugs as compared to the effects reported for non-specialty drugs, probably because specialty drugs often have no medically comparable alternatives, Doshi and her coauthors note.

«Although almost all the prior studies we reviewed were for privately insured patients from a time when cost - sharing levels were much lower than they are today, these studies still commonly found evidence that high out - of - pockets costs were associated with reductions in utilization of these drugs,» said Doshi.

Review: Glycan Utilization and Cross-Feeding Activities by Bifidobacteria — Francesca Turroni — Trends in Microbiology

To ensure effective preparation and presentation of sound budget estimates for the Department; to foster effective utilization of available resources; to ensure that financial plans are consistentwith approved plans and programs; to establish procedures for the budget phase of the Department's planning and budgeting process; to coordinate program performance planningand reporting throughout the Department, and to ensure preparation of a sound performanceplan for the Department in accordance with the Government Performance and Results Act of1993 (GRPA) and GPRA Modernization Act (GPRAMA) of 2010; to analyze resource and otherimpacts of legislative, regulatory, and budget proposals on departmental programs; to reviewthe budgetary implications of major systems acquisition programs and information technologyinvestments; to periodically conduct formal program reviews; and to assure appropriate stepsare taken on a timely basis to implement newly enacted legislation.

In one irritated review, «I was given a limit of $ 4000.00 which isn't terrible, but trying to maintain a good utilization ratio on that when you pay for everything with your credit cards is a bit cumbersome.

Residents will spend approximately 50 % of their clinical time in clinical practice activities, rotating on each of the clinical specialty services, participating and leading clinical rounds in small and large animal clinics, and performing drug utilization review on hospitalized patients.

These state agencies will also review data regarding current and future charging infrastructure utilization prior to authorizing the collection of new program costs related to transportation electrification in customer rates.

The NRC provided additional «pre-application» guidance for advanced reactor design reviews in the June 1988 NUREG - 1226, «Development and Utilization of the NRC Policy Statement on the Regulation of Advanced Nuclear Power Plants.»

Evidence Based Medicine in Workers» Compensation -(4 DVD Set) Workers» Compensation administrative systems and the courts are increasingly using Evidence Based Medicine in causation analysis, utilization review of treatment, and work ability assessment.

A general acute care hospital in Texas resolved a Stark violation involving an arrangement with a physician to provide utilization review services that did not satisfy any applicable exception.

In a scathing indictment of the over-reaching effects of ERISA preemption, Judge William Young of the United States District Court for the District of Massachusetts implored Congress to amend ERISA's civil enforcement provision to allow recovery against utilization review providers and insurers.

We also include within the definition an organized system of health care in which more than one covered entity participates, and in which the participating covered entities hold themselves out to the public as participating in a joint arrangement, and in which the joint activities of the participating covered entities include at least one of the following: utilization review, in which health care decisions by participating covered entities are reviewed by other participating covered entities or by a third party on their behalf; quality assessment and improvement activities, in which treatment provided by participating covered entities is assessed by other participating covered entities or by a third party on their behalf; or payment activities, if the financial risk for delivering health care is shared in whole or in part by participating covered entities through the joint arrangement and if protected health information created or received by a covered entity is reviewed by other participating covered entities or by a third party on their behalf for the purpose of administering the sharing of financial risk.

Some states include utilization review and similar activities in the exemption.

Similarly, some commenters, asserted that IRBs are not accustomed to reviewing and approving utilization reviews, outcomes research, or disease management programs and, therefore, IRB review may not be an effective tool for protecting patient privacy in connection with these activities.

If the participants in the IPA engage in joint quality assurance or utilization review activities, they will need to share protected health information about their patients much as participants in an integrated clinical setting would.

Comment: Several commenters noted that utilization review and internal quality review should be included in the definition.

Every single game you're seeing in this review was recorded with the device's built - in utilization of Android's ability to record its own display.

In this position we are searching for a Nurse with demonstrated expertise in Case Management / Utilization ReviIn this position we are searching for a Nurse with demonstrated expertise in Case Management / Utilization Reviin Case Management / Utilization Review

Summary: Registered Nurse for 30 years with extensive background in Case Management, Utilization Review, Skilled Care Home Car...

A minimum of 3 years of experience in a Nurse Case Manager or Utilization Review Nurse position with experience in quality strongly preferred...

The services that utilization review nurses provide to insurance companies, medical facilities, and patients help in keeping the healthcare industry free of any problems.

Planning and scheduling resources, monitoring resource utilization, and performing periodic quality reviews are all areas that I am wholly trained in.

Crossroads Treatment Centers is seeking an Administrative Utilization Review specialist to join our OTP clinic in Suffolk, VA..

We focus on containing healthcare costs for employer groups by negotiating and contracting directly with providers to capture savings, in addition to our comprehensive medical management and utilization review.

Serve as backup for technicians in the other clinical service departments (Drug Utilization Review, Medication Therapy Management, Quality Improvement)...

Registered Nurse for 30 years with extensive background in Case Management, Utilization Review, Skilled Care Home Care, Personal Care and Hospice Home Care.

Tags for this Online Resume: drug utilization review, JCAHO, organizational skills, compliance with regulatory agency regulations, performance improvement, patient safety, Medicare, Medicaid, Consultant Pharmacist, Hospital, Assisted Living Facility, Nursing Home, Skilled Nursing Facility, Intermediate Care / Mentally Retarded Facilities, Memphis, TN, 15 years experience, TN state license in good standing, PharmD

* Adept at all aspects of daily management and inventory * Strong decision - making ability * Efficient and accurate * Skilled in clinical interventions * Strong clinical background * Drug utilization review * Inventory management * Expert understanding of Medicare an...

To obtain a challenging nursing position in Case Management / Utilization Review / Occupational Health Nurse where my nursing experience, skills and abilities may be utilized to become and important asset to the organization.

Participates in daily quality / clinical review of patients profiles to ensure appropriate medication utilization and provides counseling as appropriate...

Dedicated, knowledgeable, and extremely proficient Human Services professional with more than 20 years experience, demonstrating expertise in case management, utilization review, relationship management, and cost containment strategies in state and hospital environments.

Assisted in obtaining company certifications including URAC Utilization Management Accreditation, New York State Utilization Review Agent Certification and DS Certification.

Professional Summary Nursing Professional possessing in - depth knowledge of utilization review,...

Licensed Physician and Surgeon with 24 + years of comprehensive experience in multiple fields of medicine: General Medicine, Sports Medicine, Occupational Medicine, Urgent Care Medicine, Utilization Review, Phlebology and Medicolegal Consulting.

Summary Summary Summary Education Care Manager / Utilization Review (Most recent position) * Worked in Critical Care 16 years as a staff RN caring for critically ill patients and supporting the patient and their families during the acute / chronic illness Provided care planning, implementation of care plan and revisions of individual patient plans * Managed ventilators / IABP / continuous IV infusions / conscience sedation / * RN Car...

Longtime health care professional with in - depth, versatile experience establishing and managing programs such as risk management, performance improvement, education, infection control, utilization review and case management.

My goal is to obtain a full time position as a registered nurse utilizing my phlebotomy expertise to become IV certified, board certified in rehabilitation, case management and utilization review.

Accounting and Financial Administration Professional — Duties & Responsibilities Develop and maintain a strong and extensive working knowledge of various accounting principles, regulations, tax codes, and applications, continuously applying changes to accounting landscape to current responsibilities Apply various accounting rules and procedures to critical tasks, including the review and approval of journal entries, data and financial reconciliations, balance sheet and income statement accounting, cash flow analyses, account collections, capital utilization and on - going budgetary considerations Provide relevant oversight and administration to all aspects of business finance, including billing and collections, payroll execution, vendor relationships, payroll and salary management, and other pertinent functions Perform regular book reconciliations and variance resolutions to ensure audit - ready financials and provide continuous relevant insight into the financial health of the company, in both a regular and ad - hoc manner, to company management Manage important and sensitive financial documents, receipts, and invoices on a daily basis, providing organization for audit assistance and execution as well as compliance with various accounting standards Perform analysis, research and evaluation of current accounting policies and procedures, implementing change where necessary to drive corporate efficiency, manage costs and drive revenue Facilitate the efficiency and implementation of all accounting operations from concept to execution, while coordinating actions on all daily operational and logistical aspects from corporate financial management to payroll Utilize technological resources, including software and accounting applications, to track all aspects of firm accounting and financial operations as well as prepare important and sensitive tax documents related to all aspects of organizational operations Collaborate with respect to effective communication between all departments and coordinate all daily business operations with other leadership staff and other personnel Work closely with and support senior - level management in budgeting and corporate planning strategies Address client, vendor, and management queries, resolving them in an expedited manner Assist management with various other duties as assigned to facilitate efficient administration and operations, making appropriate and effective recommendations with respect to performance optimization

Media Production Management — Duties & Responsibilities Lead through example with consistent work ethic, attitude, and professionalism, coordinating news and series production operations and communicating critical and sensitive information with various anchors, producers, reporters, editors, and other relevant parties Oversee the execution of all administrative duties, including personnel coordination, story / VO / intro drafting, live shot review, information analytics / research, and various production planning and logistical concerns Collaborate in all phases of strategic planning with other members of production crew, including topic and information utilization, dissemination strategies, viewer projections, and other relevant metrics Act as a liaison between personnel, vendors, department / unit heads, and other management partners to facilitate information flow, ensure critical and timely communications, and drive operational efficiency Research, develop, and market story ideas to senior production management, providing relevant oversight and administration to all writing, editing, and production tasks, including live - shot management and cut - in production Maintain a strong working knowledge of the all services, equipment, technologies, and other relevant information, including media trends, viewer ratings, story and series development, and general news - related conditions Perform needs - based and situational assessments of policies, protocols, and procedures to improve operational efficiency, manage and optimize program viewership, and best support personnel across production team Facilitate the organization of subject interviews, production shoots, and story development to synthesize all news and series into accurate and effective production successes Identify and utilize talent among team members with the promotion of a performance - based work environment that leverages individual talents for production benefit Provide continuous assessment of production implementation methods, while furnishing oversight and guidance regarding personnel utilization, informational flow, and series organization Manage sensitive news documents, audio / video files and recordings, and information log data in a secure, organized, and professional manner Address key queries and resolve them in an expedited manner, promoting sustained operational efficiency and production success through the supervision of critical and timely problem resolution tasks

A hospital in New Jersey is actively seeking a licensed Registered Nurse (RN), with a strong Utilization Review background,...

Director of Business — Duties & Responsibilities Recruit and train staff of 30 in hospital policies, procedures, best practices, and corporate branding Design and implement staff development, recognition, and disciplinary policies and procedures Oversee admissions, utilization review, PB X, imaging center, billing, collections, and wound center registrations Set and strictly adhere to departmental budgets and schedules Author and present financial reports concerning revenue, expenses, and outstanding collections Identify performance indicators and benchmarks for integration into reporting systems Conduct surveys regarding patient / staff satisfaction, benchmarks, accreditation, and employee benefits Maintain a 99 % patient satisfaction score through attentive and professional standards of care Negotiate contracts and claims with insurance carriers, Medicare, Medicaid, and other payer sources Increase revenue by 30 % through effective contract renegotiation with suppliers, carriers, and other parties Implement policies, procedures, and equipment to cut hospital costs while enhancing patient care Utilize strong management experience to drive operations in an efficient and professional manner Develop and implement billing controls, cash processing measures, lockboxes, and other financial processes Coordinate and oversee internal and external audits ensuring compliance with industry and legal standards Recruit physicians through successful marketing, networking, and other tactics Implement automated Chargemaster financial application (Craneware) and maintain patient accounts Responsible for HCAHPS and the yearly Quality Assurance Plan Appeal claims when appropriate resulting in $ 400,000 reimbursement from PPO insurance over the last year Build and strengthen professional relationship with community leaders, coworkers, and industry figures Consistently promoted for excellence in financial management, team leadership, and dedication to mission Develop working knowledge of hospital operations from patient admission to senior level strategic planning Represent company with poise, integrity, and positivity

(PDF - 314 KB) Baker Focal Point, 17 (1), 2003 Review of why race / ethnicity is associated with varying rates of service utilization and with differences in outcomes on standardized measures.