- ThermoFisher Scientific (Augusta, ME)
- …and annual review of their direct reports. Assists in resource utilization , policy development and implementation of goals by working with leadership in all ... and annual reviews of your direct reports. You will assist in resource utilization , policy development, and implementation of goals by working with leadership in all… more
- University of Washington (Seattle, WA)
- …one of the following: certified healthcare chart auditor, certified professional in utilization review (or utilization management or healthcare management), ... Disputes Nurse.** **WORK SCHEDULE** + 100% FTE + 100% Remote + Days **POSITION HIGHLIGHTS** The Clinical Appeals and...and communicated payer decisions in a timely manner + Review clinical denials and initiate appeals process + Conduct… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …per test for both in-house and referral tests. + Develop and chair a utilization management review committee and partner with the prior authorization team. + ... operational excellence. **DIRECTOR, LAB STEWARDSHIP AND TEST OPTIMIZATION** **|** ** REMOTE WITHIN A MARKET** The Director of Lab Stewardship... Review high-cost and high-volume referral tests for clinical appropriateness… more
- Humana (Lincoln, NE)
- …Delivery Systems, health insurance, or clinical group practice management + Utilization management experience in a medical management review organization ... us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments… more
- InGenesis (Columbia, SC)
- …In this role, you will provide support and review of medical claims and utilization practices. This is a REMOTE opportunity for a LPN living in the state ... * Review interdepartmental requests and medical information to complete utilization process * Documents process used and decision int he appropriate system… more
- ChenMed (Philadelphia, PA)
- …assess and record patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with inpatient staff for possible ... on-site at an assigned hospital daily from 9am-3pm, working remote for the remaining hours. The Acute Care Manager,...required + A minimum of one (1) year of utilization review and/or case management, home health,… more
- Koniag Government Services (Mobile, AL)
- …TGS and our government customer at Stennis Space Center, MS. This position will be remote but will require candidate to report on site to as requested by customer. ... NSSC's ServiceNow is updated to capture the processing of personnel transactions for utilization and metric purposes. The candidate will also serve as the official… more
- Veterans Affairs, Veterans Health Administration (Biloxi, MS)
- …intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, ... intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements,… more
- Banner Health (Phoenix, AZ)
- …you will participate in ethics consultation, education, and local hospital policy review . Consultation services will identify and analyze the nature of uncertainty ... norms and standards within the law and assist with utilization of resources. This is a 40 hour per...participate in ethics consultation, education, and local hospital policy review . Consultation services will identify and analyze the nature… more
- Metropolitan Council (Minneapolis, MN)
- …lifecycle management. NOTE: This position and is eligible for a hybrid (both remote and onsite) telework arrangement. The candidate's permanent residence must be in ... the new EAMS. + Assists in the implementation, configuration, utilization and overall support of the new EAMS solution....sites. What steps the recruitment process involves: + We review your minimum qualifications. + We rate your education… more