- Prime Healthcare (Anaheim, CA)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case-manager utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... information visit www.westanaheimmedctr.com. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility… more
- Prime Healthcare (San Dimas, CA)
- …Us! (https://careers-primehealthcare.icims.com/jobs/229285/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... preferred, and community focused. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the… more
- CVS Health (Phoenix, AZ)
- …difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and Transplant, ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … more
- Insight Global (Campbell, CA)
- …reviewing medical documentation and applying health plan guidelines - Experience with Utilization Management (UM) - Knowledge of commercial, Medicare, and ... Job Description - Review approximately 60 medical authorization requests per day...- Apply specific health plan guidelines and policies - Review clinical notes and identify key medical criteria -… more
- CVS Health (Columbus, OH)
- …or experience. Must reside in the state of Ohio. + Managed care/ utilization review experience + Be clinically and culturally competent/responsive with ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is… more
- CVS Health (Frankfort, KY)
- …with behavioral health background. **Preferred Qualifications** + 3 years Managed care/ utilization review experience preferred. + Crisis intervention skills and ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
- Ventura County (Ventura, CA)
- …utilize/apply the general and specialized principles, practices, techniques and methods of utilization review / management , discharge planning or case ... Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior Registered… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager, you will:** + Directs staff performance… more
- Sharp HealthCare (San Diego, CA)
- …by our recruitment and hiring teams. **What You Will Do** To provide comprehensive utilization management and coordination of care for SRS Members. Ensure timely ... be unrestricted. **Essential Functions** + Referral CoordinationEnsures consistent application of the utilization review process for effective utilization of… more
- Molina Healthcare (Iowa City, IA)
- … (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy ... **JOB DESCRIPTION** **Job Summary** Molina Pharmacy Services/ Management staff work to ensure that Molina members have access to all medically necessary prescription… more