- HCA Healthcare (Houston, TX)
- …national standards for case management scope of services including + Utilization Management supporting medical necessity and denial prevention + Transition ... at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical… more
- HCA Healthcare (Houston, TX)
- …national standards for case management scope of services including + Utilization Management supporting medical necessity and denial prevention + Transition ... at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical… more
- Microsoft Corporation (Mountain View, CA)
- … utilization strategies, and resources within budget, resulting in the utilization of resources and cost effectiveness. Drives management of stakeholder ... Global Security Investigations team, which delivers scalable, best-in-class threat management and investigative services to mitigate physical risks to employees,… more
- Highmark Health (Pittsburgh, PA)
- …referral screening/ management . **ESSENTIAL RESPONSIBILITIES** + Prior Authorization & Utilization Management : Reviews pharmacy utilization management ... for both pharmacy and medical benefits and prepares such cases for clinical review when required. Within the context of the request, applies plan-specific benefits… more
- Cleveland Clinic (Weston, FL)
- …to ensure compliance and strong performance across safety, quality, utilization and patient experience metrics and support implementation of requirements ... objectives and key results. + Model Cleveland Clinic Core Values and behavioral standards. + Coordinate with cross functional stakeholders to ensure compliance with… more
- HCA Healthcare (Nashville, TN)
- …**Responsibilities:** + Develops processes to support improved operations (such as sitter utilization , use of various pay codes, overtime management , etc.) in ... at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical… more
- HCA Healthcare (Houston, TX)
- …at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical ... assessments as directed + Manages multiple engagements concurrently, including: management of division laboratory activities, on site interviews, current state… more
- Highmark Health (Pittsburgh, PA)
- …with operational areas regarding issues related to supported technology. Manage utilization review , translation of foreign claims, coordination of benefits ... Description :** Date Posted: 20250509 Location: Allegheny General Hospital Department: Case Management , Inpatient Status: Full Time Shift: 80 hours every two weeks… more
- HCA Healthcare (Las Vegas, NV)
- …degree required. + Healthcare experience in an acute care hospital. Utilization Review , appeals, denials, managed care contracting, experienced preferred. ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...account in accordance with policies and procedures. Escalate medical review request and /or denial activities to management… more
- Ramsey County (Shoreview, MN)
- …the Department to which assigned; to function as a member of the department management group; and to perform related duties as assigned. The Services and Programs ... services with communities of color; functioning as a member of the Management and Administration Teams; tracking and reporting organizational data; and performing… more