- Commonwealth Care Alliance (Boston, MA)
- … Director of Medical Policy and Utilization Review , the Utilization Review Medical Director will be responsible for providing leadership and ... growing membership. The incumbent will have significant experience with utilization review , ideally experience with public programming,...Serve as the lead for CCA's Utilization Review functions working closely with other medical … more
- Actalent (Orlando, FL)
- …to validate the necessity and setting of care. Essential Skills + Proficiency in utilization management and utilization review + Experience with Interqual ... review the type of care being delivered, evaluate medical necessity, and contribute to discharge planning following established...program terms. If eligible, the benefits available for this temporary role may include the following: * Medical… more
- Prime Healthcare (Ontario, CA)
- …working for a Health Plan. + At least 3 years of experience in utilization review , referrals, authorizations, denials and appeals. + Current BCLS (AHA) ... of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive review of the medical record for the medical necessity,… more
- Actalent (Olympia, WA)
- …in case management and care coordination. + Experience with EPIC software. + Utilization review and appeals handling capabilities. + Discharge planning and ... program terms. If eligible, the benefits available for this temporary role may include the following: * Medical... temporary role may include the following: * Medical , dental & vision * Critical Illness, Accident, and… more
- Actalent (Sunrise, FL)
- …UMN assists in complex cases, develops internal processes, and educates physicians on utilization review issues. The role involves managing continuity of care, ... on department activities as assigned. Essential Skills + Clinical review + Utilization review +...program terms. If eligible, the benefits available for this temporary role may include the following: * Medical… more
- University of Michigan (Ann Arbor, MI)
- …authorization numbers and approval days/dates into the appropriate software system for utilization management and electronic medical records. 5. Fax clinical ... Utilization Management Assistant Apply Now **Mission Statement** Michigan...world and has been the site of many groundbreaking medical and technological advancements since the opening of the… more
- Actalent (Redlands, CA)
- …with internal staff to ensure seamless care coordination. Essential Skills + Utilization review and management experience. + Familiarity with Medicare, ... Job Title: Remote LVN Case Manager - Utilization Management Job Description Join our dynamic ...program terms. If eligible, the benefits available for this temporary role may include the following: * Medical… more
- Prime Healthcare (Inglewood, CA)
- …to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. ... Overview AtCentinela Hospital Medical Center, our dedicated team of professionals are...Clinical Coordinators. This leader will oversee all facets of utilization management, discharge planning, and care coordination to ensure… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …care experience required. + Experience - At least 3 years of experience in Utilization Review or Care Management is required or previous appeal experience. + ... + Educates all members of the patient care team, Medical Directors and Utilization Management leadership regarding...have a valid, active unencumbered Registered Nurse license or temporary permit approved by the Georgia Licensing Board. +… more
- Veterans Affairs, Veterans Health Administration (Dublin, GA)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules ... Summary The Advanced Medical Support Assistant (MSA) serves at the Dublin...Announcement" for eligible applicants to be considered for these TEMPORARY POSTIONS NOT TO EXCEED 2 YEARS. The first… more