- Catholic Health Initiatives (Lisbon, ND)
- …+ 3-5 year's current clinical experience in acute care settings + Prior Case Management / Utilization Review **Where You'll Work** CHI Lisbon Health is a 20 bed ... **Job Summary and Responsibilities** As a Case Management Professional, you will be a pivotal coordinator and advocate, guiding patients through complex healthcare… more
- Austin Industries (Irving, TX)
- …existing equipment platform and refine and develop and implement new Infrastructure based utilization and management program + Participate in the development of ... **Texas area.** The Equipment Service Manager is responsible for maximizing the utilization of Austin Bridge and Road's equipment across the project spectrum.… more
- The Cigna Group (Bloomfield, CT)
- …Architect)** We are seeking a dynamic healthcare professional to drive innovation in utilization management (UM) and Electronic Health Record (EHR) strategy. A ... Oracle Cerner, Athena, etc. highly preferred. + Experience implementing clinical programs ( utilization management , level/site of care). + Experience with process… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …internal staff and external customers, supporting formulary initiatives, and executing utilization management tools like prior authorization programs and drug ... with multiple tasks. Must have strong organizational, customer service, and time management skills, ability to problem solve. EDUCATION and/or EXPERIENCE: + Current… more
- Elevance Health (NC)
- …to get an OH License or a NC License_** + Previous experience in case management / utilization management with a broad range of experience with complex ... abuse cases preferred. + Bilingual in Spanish is highly preferred + Utilization Management experience is preferred + Previous crisis hotline is preferred _For… more
- University of Washington (Seattle, WA)
- …least one of the following: certified healthcare chart auditor, certified professional in utilization review (or utilization management or healthcare ... of experience required in one of the following areas: clinical, case management , denials, billing + Familiarity with National Coverage Determinations and Local… more
- Elevance Health (Boston, MA)
- …facility-based and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of education and ... + Supporting frontline staffing, coaching, mentoring through 1:1s and Performance management . + Partnering with Quality and Training teams. + Attending meetings… more
- Elevance Health (Grand Prairie, TX)
- …experience, which would provide an equivalent background. **Preferred Qualifications:** + Utilization management experience preferred. For candidates working in ... locations may be considered. CarelonRx delivers market-leading pharmacy benefit management and medication dispensing services to drive affordability and improve… more
- Centene Corporation (Queens, NY)
- …of managed care or medical group experience, provider relations, quality improvement, utilization management , or clinical operations. Project management ... care to our members. Participate in the development of network management strategies. Creates strategic initiatives for performance improvement. + Conducts regular… more
- FLACRA (Penn Yan, NY)
- …progress notes and other documentation required for the client medical record and utilization management within the timelines outlined by FLACRA. + Participates ... + Monitors, support, and mentors clinicians in their practice management to meet expectations for excellent client care. +...in quality initiatives and utilization review activities as requested. + Strives to understand… more