- CommonSpirit Health (Rancho Cordova, CA)
- …+ Progressive responsibilities leading up to or including supervisory role + Experience in Utilization Management , Case Management or Care Coordination, ... completing quality assurance reviews of work performed and communicating with department manager and director the outcomes of the review and any identified issues… more
- Elevance Health (Walnut Creek, CA)
- …a State agency.*_ **Preferred Skills, Capabilities and Experiences:** + 1-2 years Utilization Management experience strongly preferred. + Strong oral, written, ... with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss… more
- Elevance Health (Los Angeles, CA)
- …Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. ... clinical operational aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss… more
- Elevance Health (Denver, CO)
- …+ Experience working with addiction population strongly preferred. + 1-2 years Utilization Management experience strongly preferred. + Managed care experience ... cost of care opportunities. Works independently with oversight from immediate manager . May be responsible for an entire clinical program and/or independently… more
- CDM Smith (Detroit, MI)
- …Description:** CDM Smith is a global leader in design, program management , and construction services. We deliver innovative solutions across water, infrastructure, ... with project managers and technical mentors. Operational and Business Management - Oversee project delivery, resource planning, and workload distribution.… more
- CommonSpirit Health (Rancho Cordova, CA)
- …leading up to or including supervisory role highly preferred + Experience in Utilization Management , Case Management or Care Coordination, ... completing quality assurance reviews of work performed and communicating with department manager and director the outcomes of the review and any identified issues… more
- HUB International (Omaha, NE)
- …of benefit plan review and renewal, assists with guiding and directing the Account Manager and Financial Analyst assigned to the case , resolving questions, and ... will be responsible for providing complete service and benefit management of True Group clients (>100 lives). This includes...client agreement if it is necessary to bid the case ; directs the bidding process and prepares, or reviews… more
- Genesis Healthcare (Albuquerque, NM)
- …is required. *Experience with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization and/or case management is highly desirable. ... achievement of maximum allowable RUG categories. *Communicate with the Business Office Manager regarding case -mix data required for billing. *Educate the… more
- Global Foundries (Malta, NY)
- …Stay informed about changes in immigration laws, policies, and procedures. + Case Management : Manage a portfolio of immigration cases, tracking progress ... Keeping: Maintain accurate and confidential records of employee information and case details. Generate reports on immigration activities and outcomes as needed.… more
- J&J Family of Companies (White Plains, NY)
- …This includes working with Surgeons, Office Staff, Administration, Pain Management Specialists and Rheumatologists throughout various aspects of the product ... product and customer knowledge to present, demonstrate, and ensure proper utilization of products. Actively promote special marketing promotions and support… more