- CVS Health (Austin, TX)
- …care experience is in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience Managed Care + ... with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% ...Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live in any state.… more
- Humana (Little Rock, AR)
- …and integrated care needs for those with autism + Prior experience with Utilization Review , Utilization Management, Peer Reviews and/or Quality Management ... of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills… more
- AmeriHealth Caritas (Washington, DC)
- …to efficiently document and assess patient cases + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... + Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment + Proficiency using MS Office to include… more
- Intermountain Health (Las Vegas, NV)
- …Care Management I leads and collaborates with care management operations across utilization review , acute and emergency department care, and ambulatory/community ... Qualifications** + Previous management experience in hospital care management, utilization review , ambulatory care management, ambulatory utilization… more
- CVS Health (Baton Rouge, LA)
- …Responsibilities** + Lead, coach, and develop a multidisciplinary team responsible for utilization review , prior authorization, and case management functions. + ... do it all with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical professionals to… more
- Humana (Jackson, MS)
- …Coordinator or discharge planner in an acute care setting + Previous experience in utilization management/ utilization review for a health plan or acute care ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to...Weekly Hours: 40 + Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- Ochsner Health (Jefferson, LA)
- …relationships, contract management, standardization and consolidation processes and utilization analysis. Reviews, analyzes, negotiates, and develops contractual ... product change and serves as an internal advocate of product standardization/ utilization initiatives; coordinates new product introduction and overall product change… more
- Humana (Tallahassee, FL)
- …Qualifications:** + Experience in managed care pharmacy, particularly in utilization management review **Additional Information:** **Interview Format** ... of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting medical necessity… more
- Dartmouth Health (Lebanon, NH)
- …Required Licensure/Certifications - Licensed Registered nurse with NH eligibility * Remote :Fully Remote * Area of Interest:Nursing * Pay Range:$79,747.20/Yr. ... - $127,587.20/Yr. (Based on 40 hours per week, otherwise pro rata) * FTE/Hours per pay period:.01 hrs/per week (per diem/temp) * Shift:Rotating * Job ID:35880 Dartmouth Health offers a total compensation package that includes a comprehensive selection of… more
- Liberty Healthcare Corporation (Annapolis, MD)
- …are living with developmental disabilities + Service coordination + Case management + Utilization review + Prior authorizations + Claims reviews + Healthcare ... this initiative, Liberty is now hiring for a full-time Utilization Reviewer position. As a Utilization Reviewer,...+ Reimbursement for approved work-related mileage This is a remote first position which will allow you to primarily… more