- Humana (Juneau, AK)
- …+ Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + Demonstrated excellent time ... + Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming accreditation standards… more
- Commonwealth Care Alliance (Boston, MA)
- …Director will be responsible for providing leadership and subject matter expertise to our utilization management (UM) group. This role is a key role in helping ... other medical management team members. + Support the development of utilization management policy initiatives. + Support the development and implementation… more
- Sharp HealthCare (San Diego, CA)
- …will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM. ... will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM.… more
- BrightSpring Health Services (Louisville, KY)
- Our Company PharMerica Overview The Clinical Utilization Management Pharmacistis responsible for providing data driven consultative services to clients that ... to clients and, where required, presents the analytics themselves + Supports Account Management by providing, for key clients, business reviews with the… more
- BayCare Health System (Tampa, FL)
- …foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions ... + Required RN (Registered Nurse) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager) **Education:** + Required...Bachelors in Nursing + Preferred Masters in Nursing or Business **Experience:** + Required 2 years in Utilization… more
- BayCare Health System (Clearwater, FL)
- …foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions ... + Required RN (Registered Nurse) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager) **Education:** + Required...Bachelors in Nursing + Preferred Masters in Nursing or Business **Experience:** + Required 2 years in Utilization… more
- Ryder System (Tallahassee, FL)
- …by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The Senior Technology Business Management Analyst plays ... and partners with senior leadership to shape and execute the Technology Business Management (TBM) strategy. The role requires in-depth expertise in IT… more
- Humana (Phoenix, AZ)
- …providing frameworks to maximize available resources to achieve growth. The ** Senior Professional Business Intelligence Engineer** is an experienced individual ... of leveraging data to meet compliance requirements and define and drive business value. The Senior Professional will partner across various multi-disciplinary… more
- Moss Adams LLP (CA)
- …promote people development and maximize utilization . The Resource Management Senior will work to balance business needs with economic and operational ... business challenges. **Introduction to the team** The Resource Management Senior works with the Resource ...and analyze reports such as scheduled hours vs budget, utilization , and projections to help manage our business… more
- Houston Methodist (Sugar Land, TX)
- …and maintains accurate statistics on utilization recommendations. Provides to management and senior leadership as needed. **FINANCE ESSENTIAL FUNCTIONS** + ... At Houston Methodist, the Senior Denials Management Specialist position is...partners. This position uses sound clinical judgement in the Utilization Management process and knowledge of regulatory… more