- Elevance Health (San Antonio, TX)
- …affordability, and personalized support throughout the consumer's treatment journey. **Title:** Utilization Management Representative II - Prior ... support. **Build the Possibilities. Make an extraordinary impact.** The Utilization Management Representative II -...(demographic) information from caller. + Refers cases requiring clinical review to a nurse reviewer ; and handles… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- Excellus BlueCross BlueShield (Utica, 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)
- …encourage you to apply! Job Description: Summary: This position supports the Utilization Management (UM) workflows by providing administrative support and ... and required. + Performs other functions as assigned by management . Level II (in addition to Level...Assist with all Blue Card Claims escalations. + Assist management with the review and creation of… more
- CommonSpirit Health (Phoenix, AZ)
- …a more just, equitable, and innovative healthcare delivery system. **Responsibilities** The Utilization Management Physician Advisor II (PA) conducts ... to all constituents. **Key Responsibilities** + Conducts medical record review in appropriate cases for medical necessity of inpatient...such as Joint Operating Committee (JOC), as requested by Utilization Management or Care Management .… more
- Elevance Health (Los Angeles, CA)
- …and personalized support throughout the consumer's treatment journey._ **Title** : Utilization Management Representative II **Location:** virtual position. ... need. **Build the Possibilities. Make an Extraordinary Impact.** The ** Utilization Management Representative II ** is...provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer ; and handles… more
- Prime Healthcare (Garden Grove, CA)
- … utilization review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone ... experience, education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/206176/ utilization - review -tech- ii /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityGarden Grove Hospital… more
- Beth Israel Lahey Health (Boston, MA)
- …taking a job, you're making a difference in people's lives.** The Administrative Assistant II will support the Utilization Management team, and will work ... Data Analyst and the Authorization Administrator. This job will require good time management and multitasking at times (faxes, phones, entering info into EPIC). We… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- Summary The Utilization Management (UM) Consultant is a registered professional nurse, qualified by education and experience to work directly with physicians, ... are not creditable as related degrees. Preferred Experience: 1 year Utilization Management experience preferred. Reference: For more information on… more
- Tucson Electric Power (Prescott, AZ)
- …status -Cyber, Physical, Both or Neither (Select one) Neither Job Code TBD(I), AG017 ( II ) Safety Sensitive: Yes Last Business Unit Review Jan 2025 Position ... and vision to ensure successful business model objectives. Assure utilization of fuel gas engineering practices and compliance with...or Neither (Select one) Neither Job Code TBD(I), AG017 ( II ) Safety Sensitive: Yes Last Business Unit Review… more