- Altru Health (East Grand Forks, MN)
- …care. Collaborates with community resources to deliver services that promote quality outcomes and continuity of care. Monitors program effectiveness by evaluating, ... and participating in restructuring of current and new programs. Performs utilization review when required. Collaborates with Primary Care Provider (PCP) regarding… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Clinical Quality Nurse Reviewer RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Clinical Quality Nurse Reviewer RN II, under the… more
- Kepro (Chicago, IL)
- …. Manages the day-to-day operations for Clinical Operations, Utilization Management , and/or Clinical Reviewers, assuring quality customer service and ... + 3+ years of Case Management and/or Utilization Review experience. + Knowledge of clinical ...judgment for decision-making and guiding staff. + Experience in quality management , including involvement in projects, reporting… more
- Hartford HealthCare (Wethersfield, CT)
- …is *your moment.* **Job:** **Administrative* **Organization:** **Hartford HealthCare Corp.* **Title:** * Utilization Management Assoc / Clinical Resource ... Resource Management Associate's focus is on providing support and coordination of utilization management services for the utilization management … more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical Utilization Management ... Administration, or another relevant field + A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management with a large Health… more
- Kepro (Minneapolis, MN)
- …vital partner for health solutions in the public sector. Acentra is looking for a Utilization Management - Mental Health Clinical Reviewer to join our ... Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Long Term Services & Support Utilization Management Clinical Educator, RN** Location: Remote, United States Primary Job Function: Medical Management ... about us at www.amerihealthcaritas.com. As part of the Community Health Choices LTSS Utilization Management (UM) Review Team, the [ design title] is responsible… more
- Kepro (AR)
- …team. Summary Description The Dental Clinical Specialist is responsible for the Utilization Management and Utilization Reviews to ensure the timely ... to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions...with a turnaround time for all first-level reviews. + Utilization Management data will be reported each… more
- Randstad US (Boston, MA)
- …medical billing, coding and/or customer service experience. + Knowledge of utilization management process (ie, Health Center, Hospital, Insurance Company, ... clinical support specialist - utilization mngmt. +...Physician office) + Knowledge of Utilization Management regulations and standards + Experience with… more
- Kepro (CA)
- …a vital partner for health solutions in the public sector. Acentra seeks a Utilization Clinical Reviewer to join our growing team in California. Job Summary ... As a Utilization Clinical Reviewer, you'll harness your expertise...a focus on meeting production targets and maintaining top-tier quality assurance standards, this role serves as the linchpin… more
