- Elevance Health (Indianapolis, IN)
- **Title: Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases for… more
- Elevance Health (Latham, NY)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for managing incoming calls, including… more
- Saint Francis Health System (Tulsa, OK)
- …in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal ... the Process Improvement/Quality Director, to appropriate clinicians and to the UM Manager . Reviews eligibility and benefits of patients, matching the level of care… more
- Prime Healthcare (Montclair, CA)
- …the Case Management Department under the direction of the assigned Case Manager /Social Worker assist with development and implementations of discharge plans. Assists ... EXPERIENCE, TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and functions, in both… more
- Elevance Health (Costa Mesa, CA)
- ** Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... unless an accommodation is granted as required by law. The ** Utilization Management Representative I** is responsible for coordinating cases for precertification… more
- Elevance Health (Columbus, GA)
- ** Utilization Management Representative III** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... unless an accommodation is granted as required by law._ The ** Utilization Management Representative III** is responsible for coordinating cases for precertification… more
- South Middlesex Opportunity Council (Framingham, MA)
- …children and families. This position will coordinate billing and monitor utilization review for the Clinic and Residential Recovery Programs. Candidates must ... Working Conditions: As part of the responsibilities of this position, the Utilization Management Coordinator will have direct or incidental contact with clients… more
- Healthfirst (NY)
- …to maintain and improve department performance + Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement + Lead ... Behavioral Health, and Appeals and Grievances teams to align utilization decisions + Partner with technology and data teams...for executive-level decision-making + Experience working as a case manager for a long-term care programs such as PACE,… more
- Elevance Health (West Des Moines, IA)
- ** Utilization Management Representative II** **Location:** The selected candidate for this position must reside in Iowa. **_Virtual:_** This role enables associates ... unless an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for managing incoming calls, including… more
- CenterWell (Austin, TX)
- …Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more