- CVS Health (Columbus, OH)
- …promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team **Position Summary** The ... a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective...projects. Acting as the first point of contact for clinical issues, the Team Lead provides guidance… more
- Centene Corporation (Richmond, VA)
- …responsibility + Partner closely with claims and clinical and non- clinical Utilization Management (UM) team members to align processes and improve ... as a clinical professional on our Medical Management /Health Services team . Centene is a diversified,...fresh perspective on workplace flexibility. **Position Purpose:** Directs the utilization management team to ensure… more
- Carle Health (Champaign, IL)
- …Physician Advisor is responsible for conducting clinical case reviews referred by the Utilization Management Team , the Case Management Team , ... with the Clinical Denial Management team , the Utilization management team and the Clinical Denial Management team in defending payor… more
- Centene Corporation (Richmond, VA)
- …and communication with providers and internal clinical teams + Leads utilization management team on performance, improvement, and career growth ... as a clinical professional on our Medical Management /Health Services team . Centene is a diversified,...fresh perspective on workplace flexibility. **Position Purpose:** Directs the utilization management team to ensure… more
- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... and AHS and Behavioral Health Department of Alameda County Utilization Plan. 2. Collaborates with the treatment team...identified fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management … more
- CVS Health (Phoenix, AZ)
- …making a meaningful difference in the lives of patients? Join Mercy Care as a Utilization Management Clinical Consultant and become part of a mission-driven ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- Waystar (Atlanta, GA)
- …domestic locations for client or business meets. Preferred Requirements: + Experience leading a Utilization Management team in an acute care setting + Active ... THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the...regulations as it pertains to patient status and care management + Works effectively on a multidisciplinary team… more
- Cognizant (Salem, OR)
- …considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care ... You will be a valued member of the Cognizant team and work collaboratively with stakeholders and other teams....care revenue cycle or clinic operations + Experience in utilization management to include Clinical … more
- Martin's Point Health Care (Portland, ME)
- …since 2015. Position Summary The Supervisor is responsible for day-to-day operations of the utilization review clinical team , in the areas of authorization ... subject matter expert with specific focus on mentoring new team members, assisting with training and development, clinical...management experience in a managed care setting including utilization review + RN experience in a clinical… more
- CVS Health (Austin, TX)
- …of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of healthcare ... knowledge and expertise to enhance their understanding of utilization management principles and improve their clinical decision-making. Contributes to the… more