- University of Miami (Coral Gables, FL)
- …potential problem situations, intervenes, removes and reports defective equipment to management , Bio- Medical and Equipment Company. + Monitors preventive ... procedures such as: nerve blocks, spinals, emergency intubation + Use available RN resources when questions arise. + Takes action in emergency/rapidly changing… more
- Eastern Connecticut Health Network (Manchester, CT)
- …for preoperative, concurrent, and retrospective reviews in accordance with the utilization management plan. The UM CM ensures the appropriate status and ... accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and removing unnecessary… more
- CVS Health (Hartford, CT)
- …with internal/external clinician support as required. This position may support UM , MPO, Coding, or Behavioral Health appeals. **Required Qualifications** * Must ... have active and unrestricted RN licensure in state of residence * 3+ years...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- Elevance Health (Nashville, TN)
- …The Behavioral Health Care Manager I is responsible for conducting utilization management reviews for mental health and substance use disorder inpatient and ... necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as… more