- Access Dubuque (Dubuque, IA)
- …reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You will ... Utilization Management CNA **Cottingham & Butler/... Utilization Management CNA **Cottingham & Butler/ SISCO** 1 Positions... Management Assistant answers first level calls in Utilization Review for member participants. They will… more
- Molina Healthcare (GA)
- …of healthcare services professionals in some or all of the following functions: utilization management , care management , behavioral health and other ... one or more of the following key health care services functions: care management , utilization management , care transitions, long-term supports and services… more
- Humana (Lansing, MI)
- … (RN) license in the state of Michigan. + Previous experience in utilization management and/or utilization review . + Minimum of two (2) years of proven ... of our caring community and help us put health first** The Manager, Utilization Management Nursing (LTSS Utilization Management Leader) utilizes clinical… more
- Nuvance Health (Danbury, CT)
- …in Milliman and InterQual Guidelines required * Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum ... If unable to resolve, escalate to the PA and Utilization Review (UR) Leadership. * Coordinate with...the interdisciplinary care team * Current working knowledge of utilization management , performance improvement and managed care… more
- CareFirst (Baltimore, MD)
- …week. **ESSENTIAL FUNCTIONS:** + Trains staff on standards of practice of Utilization Management and reimbursement methodologies and treatment coding. + Manages ... required work experience. **Experience:** 5 years Experience in a clinical and utilization review roles. 1 year demonstrated progressive leadership experience.… more
- Intermountain Health (Las Vegas, NV)
- …The Manager of Care Management I leads and collaborates with care management operations across utilization review , acute and emergency department care, ... **Preferred Qualifications** + Previous management experience in hospital care management , utilization review , ambulatory care management ,… more
- CVS Health (Columbus, OH)
- …or experience. Must reside in the state of Ohio. + Managed care/ utilization review experience + Be clinically and culturally competent/responsive with ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is… more
- CVS Health (Frankfort, KY)
- …with behavioral health background. **Preferred Qualifications** + 3 years Managed care/ utilization review experience preferred. + Crisis intervention skills and ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
- Prime Healthcare (Inglewood, CA)
- …provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients… more
- CVS Health (Little Rock, AR)
- …members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the ... Nurse . + 3+ years of Managed Care experience. + 3+ years of Utilization Management experience. + 1+ year Leadership experience (formal or informal roles). +… more