- Idaho Division of Human Resources (Boise, ID)
- Utilization Review Analyst - MED Posting Begin Date: 2024/11/01 Posting End Date: 2024/11/24 Category: Accounting and Finance Sub Category: Medical ... Department of Health and Welfare is hiring a Medicaid Utilization Review Analyst in Boise...in implementation of policies and procedures for monitoring program utilization . + Confers with professional medical consultants… more
- The County of Los Angeles (Los Angeles, CA)
- …administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...for and the effective conduct of the system to review patients' medical charts to ascertain the… more
- Rush University Medical Center (Chicago, IL)
- …Surg Oncology Clinical Nurse Leader **Location:** Chicago, IL **Hospital:** RUSH University Medical Center **Department:** 14 W Tower ( Med -Surg Oncology) **Work ... clinician, outcomes manager, client advocate, educator, information manager, system analyst /risk anticipator, team lead, professional, and lifelong learner. The CNL… more
- CaroMont Health (Gastonia, NC)
- …MCO, Medicare, or RAC for reversal of original determination. May serve on the Medical Record/ Utilization Review Committee, providing detailed logs of ... medical necessity will be performed and documented in medical review , including daily status update while...NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management, Quality and/or Case… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a(an) Quote Review Analyst ? At HealthTrust, you come first. HCA Healthcare has committed up to ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...a difference. We are looking for a dedicated Quote Review Analyst like you to be a… more
- Elevance Health (FL)
- … management team. + Responsible for a team of clinicians who conduct medical necessity review for behavior analysis services. + Responsibilities include ... **JR133557 Manager II Behavioral Health Services ( Utilization Management for Behavior Analysis Services)** Responsible for...make an impact:** + Serves as a resource for medical management programs. + Identifies and recommends revisions to… more
- Medical Mutual of Ohio (OH)
- …in Brooklyn, Ohio. Eastern & Central Time Zones preferred._** Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies ... Medicare Supplement, and individual plans. **Responsibilities** Senior Employer Group Consulting Analyst Design and execute analyses and reports for clients and… more
- CVS Health (Phoenix, AZ)
- …working in the Arizona Medicaid Health system + Managed care experience + Utilization review experience + Prior authorization experience + Claims review ... to make health care more personal, convenient and affordable. **Position Summary** Utilization management is a 24/7 operation. Work schedules will include weekend,… more
- The Cigna Group (Bloomfield, CT)
- …effective and sufficient support of all Utilization Management activities to include review of inpatient and outpatient medical services for medical ... healthcare providers, members, and business partners, to optimize member benefits, evaluate medical necessity and promote effective use of resources. Medical … more
- Medical Mutual of Ohio (Brooklyn, OH)
- …Provides the interface between clinical business teams (Case Management, Clinical Claims Review , Quality Management & STARS, Utilization Management, etc.) and ... Founded in 1934, Medical Mutual is the oldest and one of...interface between clinical business teams (Case Management, Clinical Claims Review , Quality Management & STARS, Utilization Management,… more