Utilization Review Jobs in Mississippi
1 - 15 of 30
Search Results - Utilization Review Jobs in Mississippi
CommunicareOxford (MS)
standards and requirements and may participate in limited utilization review activities as assigned. The position requires the ability to interpret clinical documentation within the context of behavioral health services and apply applicable regulatory...
GainwellJackson
and technical development academies
Responsibilities
• Provide clinical guidance on policies, drug utilization, and pharmacy operations
• Perform clinical evaluations of medication therapy including prior authorization reviews and DURs
• Conduct peer-to-peer...
Dane Street, LLCPhiladelphia (MS)appcast.io
necessity and utilization review/management expertise
• Expanded credentials as an expert in Independent Medical Exams
• Fully prepped cases, streamlined case flow, transcription services at no cost, and a user-friendly work portal
Qualifications
• Board...
UnitedHealth GroupJackson
management field
• 6+ years of experience in utilization, review/management, case management, and care management
• 4+ years of experience in adult education/training including presenting materials
• Experience in healthcare hospitals and payer-based software...
Healthier Mississippi People LLCCanton (MS)
scheduling, maintaining patient records and managing the patient admissions process. To counsel with patients and family members on treatment and conditions of patients. To act as liaison between case managers, home health nurses, utilization review, etc...
UnitedHealth GroupJackson
or Marriage and Family Counseling or Licensed Ph.D. level Psychologist (independently licensed)
• Board certification as a Behavior Analyst (BCBA) and state licensure as required
• 3+ years of Managed Care and/or Utilization Review experience
• 3+ years...
Healthier Mississippi People (HMP)Jackson
scheduling, maintaining patient records and managing the patient admissions process. To counsel with patients and family members on treatment and conditions of patients. To act as liaison between Case Managers, Home Health nurses, Utilization Review, etc...
Compass Health Systems, PASouthaven
compliance with Joint Commission, CMS, state, and federal regulations.
• Assist with risk management, utilization review, and performance improvement initiatives.
• Support accreditation surveys, audits, and quality assurance activities.
• Monitor key...
Healthier Mississippi People (HMP)Jackson
scheduling, maintaining patient records and managing the patient admissions process. To counsel with patients and family members on treatment and conditions of patients. To act as liaison between Case Managers, Home Health nurses, Utilization Review, etc...
Compass Health Systems, PATupelo (MS)
compliance with Joint Commission, CMS, state, and federal regulations.
• Assist with risk management, utilization review, and performance improvement initiatives.
• Support accreditation surveys, audits, and quality assurance activities.
• Monitor key...
Wayne General HospitalWaynesboro (MS)
departments.
• Generate and review applicable Cerner reports to monitor registration activity, workflow, productivity, and patient-access processes.
Billing & Revenue Cycle Support
• Coordinate with Business Office, Billing, Utilization Review, and clinical...
Compass Health Systems, PABiloxi
compliance with Joint Commission, CMS, state, and federal regulations.
• Assist with risk management, utilization review, and performance improvement initiatives.
• Support accreditation surveys, audits, and quality assurance activities.
• Monitor key...
CumminsJackson
generation applications
• Lead project planning sessions with internal stakeholders to define scope, objectives, milestones, and performance goals
• Develop cross-functional schedules and resource plans to meet timelines and optimize utilization
• Review...
Compass Health Systems, PAMeridian (MS)
compliance with Joint Commission, CMS, state, and federal regulations.
• Assist with risk management, utilization review, and performance improvement initiatives.
• Support accreditation surveys, audits, and quality assurance activities.
• Monitor key...
Mageeicims.com
Preferred Education: Associate's, Bachelor's, or Master’s degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
• Experience: Utilization Review Expierence is Required; Clinical experience is required, or two or more years...
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