Utilization Review Jobs in West Virginia
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Search Results - Utilization Review Jobs in West Virginia
Wexford Health-Greenwood (WV)
and emergencies
• Collaborating with healthcare providers, administration, and interdisciplinary teams to coordinate patient care
• Leading and participating in committees such as Quality Assurance, Infection Control, and Utilization Review
• Supporting quality...
2 similar jobs: Avalon, Grants
Akkodis-Charleston
to improve production efficiency and material utilization.
• Review drawings, specifications, technical notes, and flow-down requirements to ensure they are incorporated into manufacturing work packages.
• Provide technical support to production teams related...
Aspire365-Charleston
in accordance with organizational policy and regulatory standards.
• Prepare documentation needed for utilization review, audits, and insurance authorization
Qualifications:
• LCSW, LMFT, LPC, LMHC or similar (Required)
• Independent Licensure is required...
UnitedHealth Group-Charleston
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...
Hope For Tomorrow-Point Pleasant (WV)
and utilization reviews.
• Participate in Performance Improvement initiatives, making adjustments where indicated to achieve all corrective action goals.
• Participate when asked, to participate in community education and marketing initiatives
• Participate...
Cummins-Charleston
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...
The Orchards-Chester (WV)
documentation of resident care, services provided, and changes in condition.
• Maintain ongoing communication with the Care Supervisor regarding resident needs and concerns.
• Participate in resident care meetings, utilization reviews, quality improvement...
UnitedHealth Group-Charleston
requirements
• 5+ years of people leadership in a healthcare setting
• 3+ years in training program development, QA operations, or organizational education
• 3+ years in utilization management operations or utilization review
• 3+ years working knowledge...
HealthPath Medical & Psychiatric Care-Charleston
for accreditation (CARF/Joint Commission), and commercial payer utilization review.
• Build referral relationships and help grow a healthy, appropriate census.
• Mentor and, as the team grows, supervise clinicians and interns and help set a positive, recovery...
Liberty Behavioral & Community Services, Inc.-Sugar Grove (WV)
organizational and documentation skills.
• Ability to work independently and manage outreach activities effectively.
• Ability to collaborate with admissions, clinical, nursing, utilization review, and program leadership.
• Appropriate professional license...
workable.com -
Ascension Recovery Services-Morgantown (WV)
Maintain strong clinical documentation standards
• Monitor client engagement, outcomes, length of stay, and discharge planning
• Support appropriate level-of-care and utilization review processes
• Ensure coordination between clinical, medical, nursing...
The Orchards-Chester (WV)
and evaluate restorative nursing programs in collaboration with nursing leadership.
• Attend and lead Medicare, Utilization Review, and interdisciplinary care planning meetings.
• Serve as the facility resource for MDS regulations, Medicare reimbursement, RUG...
The Health Plan of West Virginia Inc-Wheeling (WV)
and decision making and time management skills.
3. Ability to complete accurate and detailed supporting documentation of utilization management decisions, medication reconciliations and medication reviews.
4. Ability to work independently and carry out...
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