- Centene Corporation (Atlanta, GA)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Authorize and review utilization of dental services provided in provider ... a resource between the health plan, provider relations, and dental providers + Review treatment plans and...of Georgia + 3+ years of Utilization Management or Clinical Experience in a Dental … more
- AmeriHealth Caritas (Washington, DC)
- …meet the patient's needs in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong working knowledge of ... **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity...cases are escalated to the Medical Director for further review . The reviewer independently applies medical and… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …help us transform healthcare? Bring your true colors to blue. The RoleThe RN Utilization Management Reviewer is responsible for facilitating care for members ... to provide the best quality care. The TeamThe RN Utilization Management Reviewer is part...offer comprehensive package of benefits including paid time off, medical/ dental /vision insurance, 401(k), and a suite of well-being benefits… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Active clinical practice in order to participate in panel appeals + Experience in Utilization Management in a managed-care environment (as a clinician or in ... of the Associate Medical Director of the Physician Psychologist Review Unit, the Reviewer also provides clinical...to evaluate clinical service requests + Practice anticipatory case management for members whose cases come for review… more
- Koniag Government Services (Germantown, MD)
- …weapons design, nuclear material production, counterintelligence, weapon science, and military utilization of nuclear weapons to review and assess documents. ... Services, LLC,** a Koniag Government Services company **,** is seeking a Document Reviewer Level 5 (DRL5) with Top- Secret clearance to support **KPS** and our… more
- Koniag Government Services (Germantown, MD)
- …Professional Services** , a Koniag Government Services company, is seeking a Document Reviewer Level 2 (DRL2) with a Top-Secret clearance to support KPS and our ... offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, flexible spending… more
- Koniag Government Services (Germantown, MD)
- …Professional Services** , a Koniag Government Services company, is seeking a Document Reviewer Level 1 (DRL1) with a Top-Secret clearance to support KPS and our ... offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, flexible spending… more
- Elevance Health (Norfolk, VA)
- …Health Care Management staff by assisting in training, attending utilization management rounds, and serving on interdepartmental initiatives; assists in ... **Psychologist Reviewer ** **Hybrid 1:** This role requires associates to...external Behavioral Health Providers to ensure appropriate and consistent utilization of plan benefits, out of network services, and… more