- Unity Technologies (San Francisco, CA)
- …strategy. + Own the global mental health benefit, including vendor management , utilization tracking, and strategic enhancements + Data-Driven Optimization: ... Partner with People Analytics to design survey metrics and analyze program utilization data, using employee feedback and market benchmarking to identify trends and… more
- Humana (Miramar, FL)
- …referral source and provider interactions and communications. Work with Pre-Authorization, Utilization Management , Billing, Pharmacy, Home Care and DME regarding ... follow established procedures for approving request or referring request for further review . Provide referral management education to members and providers… more
- Leidos (St. Louis, MO)
- …ArcGIS Pro software tools in the creation, attribution, schema development and utilization , management , and geo-referencing of data. + Experience in geo-enabling ... + Utilize an understanding of geography, research, GIS, and data conflation and management skills to produce a broad array of human geography products including… more
- Humana (Frankfort, KY)
- …and interpretation skills with prior experience leading teams focusing on quality management , utilization management , discharge planning and/or home health ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Advises executives to develop… more
- Elevance Health (Las Vegas, NV)
- …or certification is a requirement for this position. + Previous experience in case management / utilization management with a broad range of experience with ... , offers superior clinical mental health and substance use disorder management , a comprehensive employee assistance program, work/life support, specialty programs… more
- Luke Staffing (Fort Bragg, NC)
- …+ Comply with regulatory, MTF, and Joint Commission quality inspection/ peer review / utilization management requirements, and applicable system applications. ... and treatment, bio-electric implanted devices, advanced vestibular assessment and treatment/ management , and amplification and signal processing technology. In diagnosing… more
- Humana (Cheyenne, WY)
- …provisioning + EPIC analyst certification/accreditations as they related to business functions ( utilization management , care management , etc ) + Previous ... OR A Bachelor's degree - Areas of consideration are: Product Management , Health Informatics, Business, Computer Science, Engineering, or related + Strategic… more
- Elevance Health (Morristown, NJ)
- …supervision.) **Preferred Skills, Capabilities and Experiences:** + Previous experience in case management / utilization management with a broad range of ... We are a third-party administrator (TPA) of medical benefits, including medical management . **Hours: 8am-5pm (Local time)** The **Behavioral Health Care Manager I**… more
- Diversicare Healthcare Services & Diversicare Ther (Bryson City, NC)
- …**Qualifications** 1. Degree in nursing. 2. Knowledge of healthcare reimbursement, utilization management , and discharge planning. 3. Experience providing ... in and facilitate Engage/72 HR Admission meetings as part of the care management system. + Manage the restorative nursing program, integrating it with the activity… more
- CGI Technologies and Solutions, Inc. (Canton, MA)
- …workflows across key functions such as claims, provider operations, member services, utilization management , care management , and finance. Ideal candidate ... accurate representation of roles, decisions, systems, compliance checkpoints, and exceptions. * Review and refine process maps, SIPOCs, and metadata for accuracy and… more