- Actalent (Atlanta, GA)
- Job Title: Utilization Review RN Location: Buckhead, GA (on-site position) Schedule: Monday-Friday, 8:30 AM-5:00 PM (Rotating weekends) About the Role We are ... seeking a detail-oriented and compassionate Utilization Review Registered Nurse (RN) to join...and benefits as needed. + Identify patients for case management programs. + Participate in quality improvement initiatives. +… more
- Sedgwick (Tampa, FL)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Utilization Review Coordinator **PRIMARY PURPOSE** : To assign utilization ... **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Accesses, triages and assigns cases for utilization review (UR). + Responds to telephone inquiries proving… more
- Centene Corporation (Sacramento, CA)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Ochsner Health (New Orleans, LA)
- …None. Preferred - 3 years of hospital-based experience in discharge planning, case management or utilization review . **Certifications** Required - Current ... individualized needs. Registered Nurse (RN) Case Manager - Case Management OMC Jefferson Highway PRN To perform this job...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
- Humana (Oklahoma City, OK)
- …. At least five years of experience post-training providing clinical services . Experience in utilization management review and case management in a ... knowledge in their daily work in their assigned cluster + Work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Atrius Health (Newton, MA)
- …. Minimum 5 years nursing experience, which includes a minimum of 3 years in utilization management or case management . . Minimum of 3-5 years clinical ... the Atrius Health practice to the patient. . Conducts review of the medical record for Atrius Health adult...degree in a related field required. Certification in Case Management (CCM) or CCM eligible preferred. Current unrestricted RN… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Medical Center. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management , and transitions of ... The Utilization Review Physician collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management , and transitions of ... **The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of… more
- Merck (Juneau, AK)
- …Content Creation, Copyright Compliance, Customer Journey Mapping, Customer Relationship Management (CRM) Utilization , Data Analysis, Design Thinking, ... **Job Description** The US Human Health Global Headquarters (HH GHQ) Asset Management Specialist's scope spans over three primary areas: + Responsible for approving… more
- Gerber Collision & Glass (Elmhurst, IL)
- …enhancements. + Develop and implement plans for continuous improvement in system utilization and efficiency. People Management : + Manage people, collaborate, and ... and Protected Veterans. Job Description: The Sr. Manager, Workday Product Management - Financials role leads the strategy, configuration, and optimization of… more
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