- CareFirst (Baltimore, MD)
- …related experience working in Care Management, Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct patient care ... and/or social determinant of health needs. Engage members and providers to review and clarify treatment plans ensuring alignment with medical benefits and policies… more
- Ryder System (Sacramento, CA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... to get things done regardless of obstacles + Optimized utilization of resources to provide a delightful and consistent...apply using the internal application process. _Job Seekers can review the Job Applicant Privacy Policy by clicking here… more
- CareFirst (Baltimore, MD)
- …by handling non-clinical tasks related to preauthorization functions, inpatient care, utilization review , care coordination and/or quality of care, enabling ... authorization requests for initial determination and/or triages for clinical review and resolution. Screens, and/or prioritizes members using targeted intervention… more
- Ryder System (Alpharetta, GA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : The Card ... reporting, and policy compliance + Prepares management reports on program utilization , spending trends, and compliance metrics for both countries + Implements… more
- CareFirst (Baltimore, MD)
- …related experience working in Care Management, Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct patient care ... and/or social determinant of health needs. Engage members and providers to review and clarify treatment plans ensuring alignment with medical benefits and policies… more
- Ryder System (Jackson, MS)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** This ... and experience in core engineering and data analysis functions (slotting, utilization , labor planning, layouts, metrics, etc.) Intermediate, Required + Knowledge of… more
- The Cigna Group (Bloomfield, CT)
- …post residency/fellowship + Knowledge of applicable state federal laws + Utilization Review Accreditation Commission and National Committee for Quality ... providers and stay current on healthcare regulations and industry developments as you review a wide range of cases. This role offers you the opportunity to… more
- Zurich NA (Schaumburg, IL)
- …medical terminology Preferred Qualifications: + 2 or more years' experience in Utilization Review , Case Management, Workers Compensation, or medical bill reviews ... Medical Bill Review Senior Nurse 127127 Zurich Insurance is currently...Agency Portal for resume submission. Location(s): AM - Schaumburg Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered:… more
- Molina Healthcare (GA)
- …guidelines + Coordinate the Market month-end close with Accounting staff; review all non-IBNR reserves for appropriateness monthly + Work collaboratively with ... impacting IBNR, including bed days and admits per 1,000, prescription drug utilization , billed dollars of inventory, and other measurable factors that may be… more
- The Cigna Group (Bloomfield, CT)
- …Cigna Medical Sales organization + Participate in client meetings and presentations to review client performance and to offer and successfully sell in a suite ... finalist meetings for new and existing business where necessary + Analyzes pharmacy utilization in order to provide clients with consultative solutions as well as… more