• UM Case Manager

    Healthfirst (NM)
    …case management, identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of ... This position is 100% Remote** **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification… more
    Healthfirst (10/07/25)
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  • Pharmacist, Utilization Management ( UM…

    Molina Healthcare (Roswell, NM)
    …medications safety and medication use policies). **KNOWLEDGE/SKILLS/ABILITIES** The Pharmacist, UM will be responsible for reviewing coverage determinations and ... in a timely, compliant, and accurate manner. The Pharmacist, UM will also be responsible for serving as a...changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary… more
    Molina Healthcare (09/25/25)
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