- Commonwealth Care Alliance (Boston, MA)
- … Director of Medical Policy and Utilization Review , the Utilization Review Medical Director will be responsible for providing leadership and ... growing membership. The incumbent will have significant experience with utilization review , ideally experience with public programming,...Serve as the lead for CCA's Utilization Review functions working closely with other medical … more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …of the interdisciplinary team. Responsibilities Duties include but not limited to: Utilization Review (UR) Registered Nurse (RN) is responsible for providing ... care. The UR RN addresses psychosocial, as well as nursing and medical needs of patients and their families/caregivers, through participation in interdisciplinary… more
- Prime Healthcare (Ontario, CA)
- …working for a Health Plan. + At least 3 years of experience in utilization review , referrals, authorizations, denials and appeals. + Current BCLS (AHA) ... of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive review of the medical record for the medical necessity,… more
- Actalent (Sunrise, FL)
- …UMN assists in complex cases, develops internal processes, and educates physicians on utilization review issues. The role involves managing continuity of care, ... on department activities as assigned. Essential Skills + Clinical review + Utilization review +...program terms. If eligible, the benefits available for this temporary role may include the following: * Medical… more
- Prime Healthcare (Inglewood, CA)
- …to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. ... Overview AtCentinela Hospital Medical Center, our dedicated team of professionals are...Clinical Coordinators. This leader will oversee all facets of utilization management, discharge planning, and care coordination to ensure… more
- Actalent (Redlands, CA)
- …will review healthcare service requests to ensure they meet medical necessity and coverage requirements, assessing them against clinical guidelines and ... of Medicare, MediCal , and Milliman Criteria Guidelines. + Experience in utilization management and working with provider offices. + Proficiency in MCG criteria… more
- Veterans Affairs, Veterans Health Administration (Dublin, GA)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules ... Summary The Advanced Medical Support Assistant (MSA) serves at the Dublin...Announcement" for eligible applicants to be considered for these TEMPORARY POSTIONS NOT TO EXCEED 2 YEARS. The first… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... Case Manager - Temporary **Position Summary** At Stony Brook Medicine, a...cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to… more
- The County of Los Angeles (Los Angeles, CA)
- ELECTION ASSISTANT III, NC ( TEMPORARY ) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/1352861) Apply ELECTION ASSISTANT III, NC ( TEMPORARY ... ) Salary $38.38 Hourly Location Los Angeles County, CA Job Type Temporary Job Number E9315C Department REGISTRAR-RECORDER/COUNTY CLERK Opening Date 12/07/2023 +… more
- Unilever (San Francisco, CA)
- THE ROLE: SENIOR SUPPLY PLANNING ASSOCIATE The Temporary Senior Supply Planning Associate plays a crucial role in OLLY's Supply Chain by interpreting demand signals ... delivery of products. + Lead regular meetings with factories and co-packers to review production plans, capacities, and constraints. + Work with factory partners to… more