- 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
- Liberty Healthcare Corporation (Salisbury, 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
- Penn Medicine (Lancaster, PA)
- …our future each day. Are you living your life's work? **LOCATION:** Fully remote position after 12-week onsite orientation **HOURS:** Full Time (40 hours per week). ... Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this critical role, you'll advocate for patients by… 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
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Shield of Minnesota Position Title: Senior Director of Health Services - Utilization Management Location: Hybrid | Eagan, Minnesota Career Area: Health Services ... us. The Impact You Will Have The Senior Director of Health Services, Utilization Management is responsible for the design, strategic planning, evolution, and value… more
- South Middlesex Opportunity Council (Framingham, MA)
- …individuals, children and families. This position will coordinate billing and monitor utilization review for the Clinic and Residential Recovery Programs. ... and in a timely fashion, for the RRS and outpatient clinic programs. + Review denials and partially paid claims and resolve discrepancies. + Assist in resolving… more
- CenterWell (Austin, TX)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and Blue Shield of Minnesota Position Title: Senior Business Analyst - Utilization Management Location: Hybrid | Eagan, Minnesota Career Area: Information Technology ... business solutions through research, audit, and analysis of data for Utilization Management. Your Responsibilities * Participates in process change and redesign… more
- Integra Partners (Troy, MI)
- …Director) with administrative and non-clinical tasks related to processing Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES + Monitor ... incoming faxes + Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS...+ Health and wellness programs + Career development opportunities Remote Opportunities We are actively seeking new colleagues in:… more
- Centene Corporation (Indianapolis, IN)
- …management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality ... of physician education with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends in utilization … more