- CVS Health (Harrisburg, PA)
- …to promote quality and effectiveness of healthcare services and benefit utilization .* Consult and lend expertise to other internal and external constituents ... in the coordination and administration of the utilization /benefit management function.* Meet set productivity and quality expectations as established by… more
- Truman Medical Centers (Kansas City, MO)
- …log into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Mgmt Nurse RN - Care Continuity - UH Truman ... **Work Schedule** 7:30AM - 4:00PM **Hours Per Week** 40 **Job Description** The Utilization Management Nurse (UM RN) collaborates with members of the healthcare team… 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
- Hackensack Meridian Health (Edison, NJ)
- …and serve as a leader of positive change. The **Care Management, Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay,… more
- Integra Partners (Troy, MI)
- The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support Integra's ... Utilization Management (UM) operations. This full-time, salaried role functions...committed to consistency, compliance, and evidence-based decision making. The Utilization Review Medical Director 's responsibilities include but are… more
- Elevance Health (Washington, DC)
- …The office is located at 609 H. Street NE.** The **Manager of Utilization Management** **ll** is responsible for managing a team of physical health practitioners ... and acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member populations. Primary duties may… more
- CareFirst (Baltimore, MD)
- …& Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health ... of business. **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement, change adoption and… more
- Dignity Health (Rancho Cordova, CA)
- …is work from home** **within driving distance of Sacramento, CA** **.** As a Utilization Review (UR) LVN, you will use clinical judgement in providing utilization ... work activities. **Job Requirements** **Minimum Qualifications:** - 3 years Managed Care/ Utilization Management (UM) experience. 5 years LVN experience. - Clear and… more
- US Tech Solutions (Chicago, IL)
- …+ Registered Nurse in state of residence + Must have prior authorization utilization experience + Experience with Medcompass **Skills:** + MUST HAVE MEDCOMPASS or ... and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF... management review. + MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions as the ... necessity of outpatient observation and inpatient stays and the utilization of ancillary services + Perform other duties as...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years in Case… more