- Humana (Montgomery, AL)
- …Degree or BSN degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + ... help us put health first** We are seeking a Senior Accreditation Professional who will work in...on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming … more
- BAE Systems (Huntsville, AL)
- …your skills and grow in your career. BAE Systems is looking for a senior -level Systems Engineer to join a strong team supporting our government customer. This ... provide the ability to make a significant impact to the mission. The senior -level Systems Engineer will: + Supervise, coordinate and/or design, develop and perform… more
- Humana (Montgomery, AL)
- …a part of our caring community and help us put health first** The Senior Utilization Management Behavioral Health Professional utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Senior Utilization Management Behavioral Health Professional work… more
- Evolent (Montgomery, AL)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to… more
- Evolent (Montgomery, AL)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Director you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent (Montgomery, AL)
- …Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Aetos Systems, Inc. (Huntsville, AL)
- …with the ability to develop technical documentation and contribute to system accreditation . Responsibilities may include: + Supervise and perform changes to network ... testing. + Provide operational support for network infrastructure by evaluating utilization , monitoring response time, and correcting system issues. + Troubleshoot… more
- Veterans Affairs, Veterans Health Administration (Montgomery, AL)
- …Medical Staff oversight. e. Plans, coordinates, and ensures high quality through utilization of multiple quality measurement tools. f. Responsible for financial and ... human resource management . g. Develops the annual strategic and budget plan...reduction in appointment wait times. k. Participates in the Senior Medical Officer of the Day on-call rotation. l.… more
- Evolent (Montgomery, AL)
- …members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director. + Appropriately ... policies + Creates adverse determination notifications that meet all accreditation , State, and Federal criteria + Uses Plain Language...identifies potential cases for Care Management programs + Communicates appropriate information to other staff… more