- Molina Healthcare (Nampa, ID)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Caldwell, ID)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or medical clinic… more
- Molina Healthcare (Caldwell, ID)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT LICENSURE… more
- Molina Healthcare (ID)
- **Job Description** **Job Summary** Provides support for member clinical review processes specific to applied behavioral analysis (ABA) services. Responsible for ... stay for requested treatments and/or procedures. * Works collaboratively with the utilization and care management departments to provide ABA and behavioral health… more
- Molina Healthcare (Caldwell, ID)
- **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** * At least 2… more
- St. Luke's Health System (Boise, ID)
- …to best support clinical and business end users in safe and efficient utilization of the electronic medical record (EMR) system. This position's job responsibilities ... are not limited to: + Serves as an initial escalation point for review of system enhancement requests impacting a single application to validate appropriateness for… more
- Sedgwick (Boise, ID)
- …(10) of related experience required to include one (1) to three (3) years utilization review experience and three (3) years clinical quality control. **Skills & ... criteria; to provide leadership within the dedicated team of clinician and claim professionals in support of the dedicated...+ Knowledge of ADAA and FMLA + Knowledge of utilization review procedures + Knowledge of clinical… more
- St. Luke's Health System (Boise, ID)
- …skills **Responsibilities:** + Serves as an initial escalation point for review of system enhancement requests impacting a single application to ... validateappropriateness for escalation to build/governance review . + Serves as project/enhancement request facilitator for enhancement and build requests as they… more
- Prime Therapeutics (Boise, ID)
- …Title** Clinical Account Manager - Remote **Job Description** Innovative business clinician accountable for building and maintaining customer relationships as well ... fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for additional… more
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