- Devereux Advanced Behavioral Health (Malvern, PA)
- …you can take your career to the next level. **Being an Admissions & Utilization Review (UR) Manager Devereux Children's Behavior Health Center has its ... longer based on the presenting symptoms. Every day as an Admissions & Utilization Review Manager you will + Supervise overall operations of DCBHC admission & UR… more
- CirrusMD (Denver, CO)
- …growth by identifying upsell opportunities, growing membership/employee lives, and meeting utilization goals. What You'll Do + Responsible for growing and retaining ... assigned clients, including finding product upsell opportunities and increasing utilization in partnership with the marketing team + Manage large strategic accounts,… more
- CVS Health (Hartford, CT)
- …their clinical quality and effective use of health care resources. This is a remote based (work at home) based anywhere in the US. **Responsibilities of this Medical ... D pharmacists; supervision and participation in the Second Look Review (SLR) process * Provide direct support to the...24/7 appeals work * IRE monitoring and tracking and Utilization Management Strategy support * Develop subject matter expertise… more
- Parexel (Hartford, CT)
- **Job Title:** Data Management Lead (Medical Affairs) - Oncology **Location:** Fully Remote (US based) Must be able to accommodate West Coast hours. **About Us:** At ... solutions, and ensure high-quality, compliant data. + Use surveillance tools to review data at an aggregate level, identifying patterns or anomalies to ensure… more
- Commonwealth Care Alliance (Boston, MA)
- …claims adjudication, clinical coding reviews for claims, settlement, claims auditing and/or utilization review required + 7+ years experience with Optum Claims ... for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other...regulations. The role will also be responsible for timely review and research, as necessary on all new and… more
- Beth Israel Lahey Health (Charlestown, MA)
- …familiarity with CPT/HCPCs/DRG coding experience required. * Clinical education and/or utilization review experience is strongly preferred. * Requires minimum ... making a difference in people's lives.** This is a remote based role. Reporting to the Manager, Patient Financial...managers are involved. * Assist in the tracking and review of payer audit and denial results. Prepare appeal… more
- BrightSpring Health Services (San Antonio, TX)
- …OPPORTUNITIES MUST BE A FULLY LICENSED BCBA IN THE STATE OF TEXAS HYBRID REMOTE WORK AND FLEXIBLE SCHEDULE! We are seeking a Youth Behavioral Clinic Supervisor that ... professional teams. Provide staff/family training on implemented programs. + Review all Functional Behavior Assessments/Behavior Support Plans prior to… more
- BrightSpring Health Services (Valdosta, GA)
- …report any discrepancies to BM. + Run monthly End of Month reports. + Run and review Utilization - Work all over utilized clients to prevent SVPs. + Time Detail ... report any changes to Business Office Manager. + Web Portal Patient Monthly Liability Review monthly - send any changes to Business Office Manager. + Verify weekly… more
- University of Miami (Deerfield Beach, FL)
- …via in-basket messaging. + Extensive collaboration with providers, nursing unit, and utilization review department in coordinating admissions. CTU + Must possess ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of… more
- University of Miami (Miami, FL)
- …via in-basket messaging. + Extensive collaboration with providers, nursing unit, and utilization review department in coordinating admissions. CTU + Must possess ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of… more