- Elevance Health (Denver, CO)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... + Experience working with addiction population strongly preferred. + 1-2 years Utilization Management experience strongly preferred. + Managed care experience… more
- Elevance Health (Los Angeles, CA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience.… more
- CDPHP (Latham, NY)
- …The pharmacy tech will participate in an on-call/holiday rotation along with a utilization management pharmacist to support Plan members in after hour pharmacy ... clear understanding of prescription and medical benefits as it applies to the utilization review process. + Must demonstrate proficient experience with the… more
- Henry Ford Health System (Troy, MI)
- …relevant contractual requirements and issues to internal customers such as Utilization Management , Finance, Patient Billing, Administration, Legal, etc. 7. ... Payors and facilitate resolution of contracting and operational issues, ie billing, utilization review , credentialing site visits, notification of site closures… more
- CommonSpirit Health (Rancho Cordova, CA)
- …responsibilities leading up to or including supervisory role + Experience in Utilization Management , Case Management or Care Coordination, Managed ... performed and communicating with department manager and director the outcomes of the review and any identified issues or barriers. **Core Duties:** + Compiles data… more
- St. Luke's University Health Network (Sellersville, PA)
- …clinical mental health/crisis intervention experience required. Previous experience with case management / utilization review and managed care models ... who may require treatment with seclusion/restraints. + Supports the function of utilization management regarding pre-certification process for all intakes and… more
- CommonSpirit Health (Rancho Cordova, CA)
- …leading up to or including supervisory role highly preferred + Experience in Utilization Management , Case Management or Care Coordination, Managed Care ... and communicating with department manager and director the outcomes of the review and any identified issues or barriers. **Accountabilities:** + Compiles data for… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Blue Cross Blue Shield of MN! This role is a key contributor to our Utilization Management team, helping to shape smarter, data-driven decisions that improve how ... degree. * Experience with health care data (focus on Utilization Management a plus) * Experience with...discover more about what we have to offer, please review our benefits page. Role Designation Hybrid Anchored in… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print...Review Nurse is an RN that has Case Management experience whose primary charge is to ensure that ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 - $167,136.48 Annually… more
- Aerotek (Cuyahoga Falls, OH)
- …and Workzone requirements. + Operate machines to achieve maximum throughput and utilization . + Inform management of anticipated and actual completion times. ... years, this role promises stability and growth. **Responsibilities** + Review the Production Part Machine schedule daily. + Understand...+ Notify management of anticipated conflicts for future operations. + Perform… more