- Humana (Lincoln, NE)
- …and help us put health first** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical expert responsible for conducting medical necessity ... required. Mandatory overtime during peak season.** **Job Description:** The Staff Utilization Management Pharmacist (VSP/PT)...**Job Description:** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical professional… more
- Humana (Lincoln, NE)
- …part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments… more
- Sedgwick (Lincoln, NE)
- …to verify and enter data in appropriate system(s); and to provide general support to clinical staff in a team environment. **ARE YOU AN IDEAL CANDIDATE?** We are ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Utilization Review Coordinator **PRIMARY PURPOSE** : To assign ...+ Enters demographics and UR information into claims or clinical management system; maintains data integrity. +… more
- CenterWell (Lincoln, NE)
- …for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, ... documentation in addition to feedback and recommendations by Utilization Review staff . Upon completion of the...systems and process. Competently performs patient care assignments and staff management activities. + Provides direct patient… more
- CenterWell (Lincoln, NE)
- …for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, ... documentation in addition to feedback and recommendations by Utilization Review staff . Upon completion of the...systems and process. Competently performs patient care assignments and staff management activities. + Provides direct patient… more
- Highmark Health (Lincoln, NE)
- …and financial stakeholders **Preferred** + Experience with medical policy and utilization management functions + Medical coding experience **LICENSES or ... Utilize robust, data-driven insights from complex healthcare datasets (eg, claims, clinical , utilization , pharmaceutical) to inform policy development, identify… more
- Organon & Co. (Lincoln, NE)
- **Job Description** **The Position** The Women's Health Clinical Account Specialist supports customers by providing clinical information on our Company's ... products, as well as education, and supporting clinical training programs. They do this to support customer...Planning Counselors, Office and Pharmacy Managers and other Support Staff . Within their geography, there are a diverse set… more
- CommonSpirit Health (Omaha, NE)
- …and optimization requests to drive performance improvement through the deployment and utilization of new and existing clinical Health IT systems. **ESSENTIAL ... staff departmental teams, informatics staff , IT staff , corporate staff , System Clinical ...business sponsor for new changes and model effective change management strategies. Serve as a role model for innovation… more
- Fresenius Medical Center (Grand Island, NE)
- …courses and that licensures/certifications are current. + Provides support for all clinical staff members at regular intervals and encourages professional ... eligibility for treatment. + Reports changes in patient status regarding any clinical , insurance, or travel and transportation issues. STAFF : + Participates… more
- Evolent (Lincoln, NE)
- …is responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under ... directed by the office of the Chief Medical Officer. + Responsible for clinical conversations with providers and their office staff regarding medical necessity… more