- Amergis (Rancho Cordova, CA)
- …charge/lead/supervisory/ management experiencerequired Amergis Healthcare Staffing is seeking a Supervisor Utilization Management Prior Authorization ... Salary: $1760 / Week Supervisor Utilization Management PriorAuthorization Anticipated Duration: ASAP - 3 monthcontract Location Address: Rancho Cordova CA… more
- Centene Corporation (Jefferson City, MO)
- …key initiatives and to facilitate on-going communication between utilization management team, members, and providers + Monitors prior authorization, ... Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure… more
- Centene Corporation (Tallahassee, FL)
- …licensure as outlined by the applicable state required. Knowledge of BH utilization management principles preferred. Prior supervisory experience preferred ... to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization … more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …coordinates and is accountable for the daily work of employees who provide utilization management , clinical and medical necessity claim related services and ... PT, NP, PA, or Dietician) with a minimum of three years of utilization management /quality improvement experience or equivalent required. + Must possess a… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …Healthcare providers, subscribers, claims, appeals, legal, networking, case management , customer service, and compliance. **QUALIFICATIONS** **Education** + ... managed care experience or three years BCBSLA + Care Management experience with progressive levels of responsibility and expertise...drug screening after an offer has been extended and prior to hire for all positions. As part of… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA… more
- AmeriHealth Caritas (LA)
- …the direction of a supervisor , the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... in a fast-paced environment. ;The Clinical Care Reviewer - Utilization Management will also be counted upon...home healthcare or a medical office setting. + Previous prior authorization experience is required.; + Proficiency in Electronic… more
- Actalent (Sunrise, FL)
- Utilization Management Nurse!Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization requests to ... Working under the general supervision of the Director and/or Manager/ Supervisor of Medical Management , and in collaboration...activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management … more
- Excellus BlueCross BlueShield (Rochester, NY)
- …encourage you to apply! Job Description: Summary: This position supports the Utilization Management (UM) workflows by providing administrative support and ... attendance is expected and required. + Performs other functions as assigned by management . Level II (in addition to Level I Accountabilities) + Assists and performs… more
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