- BriteLife Recovery (Englewood, NJ)
- …Minimum of 2-3 years of experience in utilization review , case management , or insurance coordination in a behavioral health or substance use treatment ... What you will be doing? The Utilization Review (UR) Specialist is a...Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in… more
- CVS Health (Austin, TX)
- …is in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience Managed Care + Strong ... do it all with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live… more
- McLaren Health Care (Flint, MI)
- …to help people live healthier and more satisfying lives. We are looking for a Utilization Management RN, to join in leading the organization forward. MHP is a ... our members. **Position** **Summary:** This position is responsible for utilization management functions. This includes but is... functions. This includes but is not limited to review and authorization of services, utilization of… more
- Georgetown Behavioral Health Institute (Georgetown, TX)
- …bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator. This position is responsible for working with ... our team. Georgetown Behavioral Health Institute is a 118...insurance coverage and billing practices preferred. Previous experience in utilization review or case management … more
- Highmark Health (Harrisburg, PA)
- …Highmark Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of ... UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Saint Francis Health System (Tulsa, OK)
- …participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of ... support to the hospital and treatment team throughout the review of patients, their placement in various levels of...and benefits of patients, matching the level of care utilization . Assures compliance with Managed Care Behavioral … more
- LifeCenter Northwest (Bellevue, WA)
- …case activity or operational needs. + Collaborate with the Director, Organ Utilization , to manage departmental budgets and identify cost- management opportunities ... Position Type Full Time Description and Qualifications The Manager, Organ Utilization (OUM) provides strategic leadership and operational oversight for the Organ… more
- LifeCenter Northwest (Bellevue, WA)
- …Salary Position Type Full Time Description and Qualifications The Director, Organ Utilization (Director), is responsible for overseeing the processes and teams that ... and executes strategies to improve organ allocation strategy and organ utilization , collaborates closely with transplant programs and the surgical recovery team… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... access the full range of their benefits through the utilization review process. + Conducts admission reviews....degree such as nursing, social work, psychology, health information management or other related healthcare field is preferred or… more
- Healthfirst (NY)
- …closely with other Operations leaders including but not limited to Care Management , Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams ... to maintain and improve department performance + Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement + Lead… more