- ERP International (Vandenberg AFB, CA)
- **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Utilization Management ** for a temporary contract position in support of ... AFB, CA (https://www.airforcemedicine.af.mil/MTF/Vandenberg/About-Us/) . **NOTE: This is NOT a Tele-Health/ Remote Practice Opportunity.** **Be the Best!** Join our team… more
- CVS Health (Little Rock, AR)
- …members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the ... Travel Required up to 5% for meetings/audits. Location: 100% Remote (US only) **About Us** American Health Holding, Inc....years of Managed Care experience. + 3+ years of Utilization Management experience. + 1+ year Leadership… more
- Ascension Health (Baltimore, MD)
- **Details** + **Department:** Utilization Management + **Schedule:** Part-time. Monday-Friday, 8:00AM-4:30PM. + **Facility:** Ascension St. Agnes Hospital + ... **Location:** Partially Remote ; with onsite coverage required in Baltimore, MD +...coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure… more
- Centene Corporation (New York, NY)
- …and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a ... benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for… more
- Centene Corporation (Sacramento, CA)
- …experience with prior auth is highly preferred** **Position Purpose:** Directs the utilization management team to ensure the appropriate application of policy ... manages Utilization Operations specific to the daily operations of Utilization Management including timeliness, quality and performance outcomes, provider… more
- Centene Corporation (Columbus, OH)
- …IN STATE OF OHIO IDEAL CANDIDATE WILL HAVE PRIOR AUTHORIZAION OR UTILIZATION MANAGEMENT EXPERIENCE PEOPLE LEADER EXPERIENCE STRONGLY PREFERRED **Position ... Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure… more
- Centene Corporation (Phoenix, AZ)
- …ensure appropriate care to members. Oversees and works with senior leadership on utilization management issues related to member care, provider interactions, and ... facilitates operations within utilization management . + Oversees the behavioral health...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- Humana (Olympia, WA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...Weekly Hours: 40 + Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- Humana (Richmond, VA)
- …part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments… more
- CVS Health (Frankfort, KY)
- …all with heart, each and every day. **Position Summary** This is a fully ** remote ** Utilization Review Clinical Consultant. **Must reside in the state of ... and external constituents in the coordination and administration of the utilization /benefit management function. + Utilizes clinical skills to coordinate,… more