- Centene Corporation (Indianapolis, IN)
- …offering competitive benefits including a fresh perspective on workplace flexibility. ** Remote Opportunity** **Centene is Hiring - Remote Psychologist Reviewer ... our growing markets and ensure clinical excellence.** **Why Join Us?** **. 100% remote flexibility** **. Meaningful work improving care for youth with Autism** **.… more
- Elevance Health (New Hyde Park, NY)
- …regarding case and determines appropriate area to refer or assign case ( utilization management, case management, QI, Med Review ). + Provides information ... reports and documents all actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical… more
- CommonSpirit Health Mountain Region (Centennial, CO)
- …indicated through research and coordination of completion of medical records and utilization review processes. Identifies areas for documentation and/or process ... experience as a Registered Nurse. 3 years with progressive experience in utilization review , preferred. Prior experience writing clinical denial appeal letters… more
- V2X (Madison, MS)
- …operations and -10 level range equipment maintenance, land conditions and utilization . He/she will supervise multiple OCN technician augmentees in accordance with ... ICW the planning team. + Monitors range-land conditions and utilization . + Conducts range monitoring & use in accordance...preferably in Combat Arms. + Able to operate in remote and austere environments. + Working knowledge of Geographic… more
- Banner Health (Sun City West, 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
- 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