Sentences with phrase «utilization review services»
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.
http://www.healthlaw-blog.com/ Not exact matches
We provide a vast wealth of knowledge through the utilization of e-newsletters, mailing lists, peer - reviewed journal articles, & books so access to information regarding school nutrition services is easy & straightforward.
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.
(v) Utilization review activities, including precertification and preauthorization of services.
(v) Utilization review activities, including precertification and preauthorization of services, concurrent and retrospective review of services; and
Collaborate with the client's existing utilization review, case management, and member services staff to ensure appropriate resource allocation and utilization by all members
Review and analyze facility activities and data to aid planning and cash and risk management and to improve service utilization.
Analyzed and reviewed the activities of health care staff as well as improved the utilization of services
The services that utilization review nurses provide to insurance companies, medical facilities, and patients help in keeping the healthcare industry free of any problems.
Review services and complete utilization management activities.
Performed all administration services to health plans, services including pre-certification, utilization review, and claims notification.
The utilization review manager resume sample writer didn't just list «review clinical information, coordinated services, consulted with patients, and prepared reports.»
EnvisionRx, with a commitment to providing transparency and disclosure to the Pharmacy Benefit Management (PBM) marketplace, provides full service, integrated PBM services, including network - pharmacy claims processing, mail order, benefit design consultation, drug utilization review, formulary management, and other related services.
(Reference Code: KAM) Position Title: Utilization Review Nurse / RN Case Manager Reports to: Director Clinical Services SCOPE: Responsible for determining medical necessity...
Conducted application review to assess appropriate utilization of services from admission through discharge Kept both patient and physician informed as to patient's progress through the hospital structure.
Serve as backup for technicians in the other clinical service departments (Drug Utilization Review, Medication Therapy Management, Quality Improvement)...
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.
• Skilled at using case management software, navigate Medical web services and use Interqual and Millman criteria for utilization review.
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
Tags for this Online Resume: customer service, case management, utilization review, quality assurance, social service management, healthcare, behavioral health, training
Description: EK Health Services is looking for an Indexer for our Utilization Review department.
Core Competencies Case Management • Utilization Review • Plan Development • Condition Code 44 • Operations Management • Patient Relations • Healthcare Services • Business Development • Program Development Recruitment & Training • Budgeting • Medical Instruction • Medical Assistance • Patient Care Placement Team Leadership • Operations Improvement • Communications • Program Management
Professional Experience Qualis Health (Boise, ID), Director of Idaho Medicare Operations 2007 — Present Qualis Health (Boise, ID), Project Manager 2003 — 2007 Cascade Medical Center (Cascade, ID), Director of Operations & Healthcare Services 2001 — 2003 Shepard's Home, Inc. (McCall, ID), Executive Director 1999 — 2001 Independent Consultant (CA & ID) 1992 — 1999 CIGNA (San Diego, CA), Director of Provider Relations & Director of UM / QA 1985 — 1991 Sharp Memorial Hospital (San Diego, CA), Managing Director Utilization Review 1984 — 1985 State of California, Department of Mental Health (Sacramento, CA) Health Care Services Nurse; Mental Health Specialist II 1980 — 1984 Greater Sacramento PSRO (Sacramento, CA), Registered Nurse 1977 — 1980 Sacramento Community Hospital (Sacramento, CA), Registered Nurse 1976 — 1977 St. Benedict's Hospital (Jerome, ID), Registered Nurse 1969 — 1975
Reviews 16 peer - reviewed articles and / or research reports to identify lifetime and past year prevalence rates of mental health disorders and service utilization.
Mental Health and Substance Use Disorders Among Foster Youth Transitioning to Adulthood: Past Research and Future Directions Havlicek, Garcia, & Smith (2013) Children and Youth Services Review, 35 (1) View Abstract Reviews 16 peer - reviewed articles and / or research reports to identify lifetime and past year prevalence rates of mental health disorders and service utilization.
(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.