- Elevance Health (Washington, DC)
- …office 4 days each week. The office is located at 609 H. Street NE.** The ** Utilization Management ** ** Manager ll** is responsible for managing a team of ... and acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member populations. Primary… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works...assigned work in a timely and accurate manner + Knowledge of the Utilization management … more
- New York State Civil Service (New York, NY)
- NY HELP No Agency Empire State Development, NYS Title Project Manager , Utilization - MWBE Occupational Category Other Professional Careers Salary Grade NS ... the direct supervision of the Director of Contract Participation, the Project Manager , Utilization , will lead the planning, execution, and monitoring of… more
- Prime Healthcare (Anaheim, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case- manager utilization - ... in case management , discharge planning or nursing management ; 2. Experience and knowledge in basic...5 years of acute care experience preferred.2. Certified Case Manager (CCM) certification preferred.3. At least one-year experience in… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management… more
- Catholic Health Services (Melville, NY)
- …current with industry standards and business objectives related to Utilization and Care Management as appropriate. + Sound knowledge and skill in the use of ... was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts...additional clinical documentation. + Acts as liaison between the Utilization and Appeals Management Department and the… more
- Prime Healthcare (Montclair, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/226814/case- manager utilization - ... or management , preferred. + Current BCLS certificate preferred. + Knowledge of Milliman Criteria and InterQual Criteria preferred. Pay Transparency Montclair… more
- Ochsner Health (Jefferson, LA)
- …This job manages expense management , vendor relationships, contract management , standardization and consolidation processes and utilization analysis. ... supply utilization improvements. + Good judgment, organizational and time management skills. + Consulting and group presentation skills. + Ability to travel… more
- AdventHealth (Altamonte Springs, FL)
- …**Job Location** : Remote **The role you will contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by ... strategies including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable for a designated patient… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred: Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or CM. Knowledge of Department of Health ... Utilization Management Admissions Liaison RN II...current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) American Case Management Association (ACM)… more