- Molina Healthcare (Mesa, AZ)
- …state they reside. We are looking for a RN Manager to manage a utilization management team supporting 14 Marketplace plans. Home office with internet ... performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more
- Evolent (Phoenix, AZ)
- …mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Utilization … more
- CenterWell (Phoenix, AZ)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- HonorHealth (Phoenix, AZ)
- …Phoenix Hours: Full-Time Days, Monday-Friday, rotating Saturdays Prior Experience in Home Infusion Strongly Preferred $5,000 Sign-on-Bonus Available! Looking to be ... programs and practices within the hospital as well as medication order review with accuracy; check technician-prepared products before release; maintain security of… more
- PennyMac (Phoenix, AZ)
- …evaluate processes to ensure application of best practices and maximize staff utilization + Provide support to production staff regarding underwriting and credit ... Pennymac has helped over 4 million lifetime homeowners achieve and sustain their aspirations of home . Our vision is to be the most trusted partner for home .… more
- Humana (Phoenix, AZ)
- …explain the rationale behind utilization management decisions, + Work includes computer- based review of moderately complex to complex clinical scenarios, ... least 2 years of experience post-training providing clinical services . Experience in utilization management review and case management in a health plan setting… more
- Evolent (Phoenix, AZ)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more
- Molina Healthcare (Scottsdale, AZ)
- … management, risk management, risk adjustment, disease management, and evidence- based guidelines. + Experience in Utilization /Quality Program management ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
- Molina Healthcare (Mesa, AZ)
- … management, risk management, risk adjustment, disease management, and evidence- based guidelines. + Experience in Utilization /Quality Program management ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
- Evolent (Phoenix, AZ)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Director you will be a key member of the utilization management team. We can offer you a meaningful...the regulatory timeframe of the request. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more