- Elevance Health (Wallingford, CT)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases… more
- Elevance Health (Cincinnati, OH)
- ** Utilization Management Representative II** **Schedule: Monday-Friday 8am-5pm Eastern Time** **Must be located near one of our Ohio PulsePoint offices in ... benefits and/or eligibility information. + May act as liaison between Medical Management and internal departments. + Responds to telephone and written inquiries from… more
- Tufts Medicine (Burlington, MA)
- … review and management . The position develops and leads the Utilization Management operations, strategy and implementation of the Utilization ... of Science in Nursing (BSN). 2.Massachusetts RN Licensure. 3. Current certification in case/ utilization management (ACM, CCM, CMAC) 4. Seven (7) years of UM/Case… more
- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. The Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical ... service authorization review for medical necessity and decision-making. The Utilization Management Reviewer has a key role...Physical Requirements: * The physical demands described here are representative of those that must be met by an… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I ... comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're working… more
- Sanford Health (Fargo, ND)
- …credit added to wage ** **Department Details** This role will be supporting the Utilization Management team in various administrative tasks. We are seeking a ... to changes. **Job Summary** Two major functions of the Patient Access Representative (PAR) are patient registration and scheduling. Depending on setting, the PAR… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …Oversee and direct work activities of unlicensed clinical staff involved in the utilization management process. + Communicate with ABA providers to gather ... policies. + Participate in the development and refinement of utilization management protocols and clinical review tools....behavioral health settings. _The Physical Demands described here are representative of those that must be met by an… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …and/or service decisions. + Document clinical decisions and rationale in the utilization management system. + Communicate determinations to providers and members ... records and case management systems _The Physical Demands described here are representative of those that must be met by an employee to successfully perform the… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Case Management Representative position is responsible for providing clerical assistance and data management support to the case ... management and social work department to facilitate efficient utilization of resources and discharge planning including referrals management , communication… more
- Grifols Shared Services North America, Inc (Minneapolis, MN)
- …110 countries and regions. **Overview:** The primary responsibility of the Bleeding Management Hospital Specialty Sales Representative (HSSR) is to represent key ... products within the Bleeding Management product portfolio with a primary responsibility for the...protocol changes within their related area of practice. + Utilization of corporate resources including the Key Account Manager,… more
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