- Cipla (Fall River, MA)
- Job Title MDI Operations Specialist Organization Name InvaGen Pharmaceuticals, Inc. Location Fall River location Employment Type Full Time Shift Second Shift Salary ... disability (LTD), parental leave, employee discounts, and other benefits. Work Hours/ Shift/ Remote General Shift: 15:00 - 23:30 (may vary based on business needs)… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization Review Specialist will perform prospective, ... Preferred **Experience:** 5 years Clinical nursing experience. 2 years Care Management and/or Utilization Management . **Preferred Qualifications:** + … more
- Spectrum Billing Solutions (Skokie, IL)
- …mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist | Revenue ... in a cohesive and rewarding environment. This is a remote or office/home hybrid position. Your Responsibilities: + Review... Utilization Review Specialist | ABA Utilization Management Specialist | ABA… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of ... hospital services to ensure compliance with utilization management policies. This role conducts admission and continued stay reviews, supports denials and… more
- Ascension Health (Austin, TX)
- **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday, Days + **Location:** Remote + **Pay:** $93,857 - $126,983 + Eligible ... assist with the budgeting process. + Serve as content specialist for staff in the areas of utilization...years of related experience is required. **Additional Preferences** + Utilization management experience strongly preferred. **Why Join… more
- Henry Ford Health System (Troy, MI)
- …records and related documentation. + Current working knowledge of hospital operations, utilization management , case management , and managed care ... The purpose of the Central Authorization Specialist position is to centrally facilitate the successful...is obtained from back end coding, billing and denial management resources and distributed to ordering physicians and authorization… more
- UPMC (Pittsburgh, PA)
- …+ Provide innovative ideas for new and existing clinical program development, utilization management , formulary management , provider education, and ... Health Plan has an exciting opportunity for a Senior Clinical Pharmacy Specialist in the Pharmacy Services department. This is primarily a work-from-home position… more
- Mayo Clinic (Rochester, MN)
- …to support accurate DRG assignment and defend coding-related denials. Experience in utilization review, case management , denials and appeals, revenue cycle, or ... prior authorization preferred. Knowledge and use of discharge planning, case management , utilization review, and levels of care criteria. Familiarity with… more
- Sharecare (Oklahoma City, OK)
- …and HIPAA regulations. This role also provides support to team members and management by serving as a subject matter expert, trainer, and escalation point. The ... or system issues. + Assists with administrative tasks such as queue management and work assignments. + Produce reports and metrics as requested. **Qualifications:… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and Blue Shield of Minnesota Position Title: RN Specialist Complex Case Management - Transplant Location: Remote Career Area: Health Services About Blue ... Transplant Management ! Utilizing key principles of case management , the RN Specialist will research and...* 2+ years of managed care experience; eg case management /health coach, utilization management and/or… more
