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$269.5k - $425.5k
...member of a team of medical directors, for the overall quality, effectiveness and coordination of the medical review services. Additionally, performs Utilization Management reviews and directs/coordinates aspects of the utilization review staff activities, and...SuggestedMinimum wageFull timeWork experience placementLocal areaRemote workWeekend workUnitedHealth Group
United States1 day ago- ...opportunity with the requirement to come onsite as needed. You may be based outside of the greater Chicagoland area. The Manager of Utilization Review (UR) provides leadership and oversight of utilization review activities across the health system, including the academic...SuggestedFull timeContract workWork from homeShift work
The University of Chicago Medical Center
Harvey, IL4 days ago $3,044 per week
...hours a week for 13 weeks in Bozeman, Montana. Vivian Health provides transparent Travel Med Surg Salary information and unbiased reviews from leading Travel Nurse Agencies across the United States, so you can compare travel opportunities matching your desired...SuggestedDaily paidContract workImmediate startShift workPremier Medical Staffing Services
Bozeman, MT4 days ago$65k - $88.6k
...of our caring community and help us put health first The Utilization Management Behavioral Health Professional 2 utilizes behavioral... ...Perform accurate and timely initial and ongoing treatment reviews with documentation in MSR reflecting determination of appropriateness...SuggestedBi-weekly payFull timeContract workTemporary workApprenticeshipInterim roleWork at officeRemote workWork from homeHome officeMonday to FridayShift workWeekend workHumana
Saint Paul, MN8 hours ago$223.8k - $313.1k
...prioritizing health! The Medical Director plays a vital role in reviewing and determining the authorization of requested services and... ...position operates under strict regulatory compliance while utilizing a range of resources including national clinical guidelines, CMS...SuggestedRemote workMonday to FridayWeekend workHumana
Salem, OR1 day ago- ...strategy and support process improvements. # Review complex client rebate models and convert... ...to ensure modeling accurately reflects utilization management programs and rebate contract... ...Health Services, a division of The Cigna Group, creates pharmacy, care and benefit...SuggestedContract workLocal areaWork from home
$60.79 - $74.4 per hour
...family/caregivers, staff and appropriate community agencies. Reviews, monitors, evaluates and coordinates the patients hospital... ...interdisciplinary approach to providing continuity of care, including Utilization management, Transfer coordination, Discharge planning, and...SuggestedFull timeWork at officeLocal areaShift workWeekend workKaiser Permanente
Los Angeles, CA4 days ago$248.5k - $373k
...expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools... ...primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and...SuggestedMinimum wageWork experience placementLocal areaRemote workPhoenix Staffing Services
Phoenix, AZ8 hours ago$223.8k - $313.1k
...provided through additional weekdays off. Your role entails reviewing submitted medical records, analyzing complex clinical... ...Demonstrate adaptability and a willingness to learn new workflows and utilization management practices. Weekend work required one weekend...SuggestedFull timeWork at officeWeekday workHumana
Atlanta, GA4 days ago- ...appropriate hospital staff including treating physician, PCP, utilization managers, social workers, discharge planners. Assures appropriate... ..., recruitment and selection, performance appraisals, salary reviews and staffing. Bachelor's Degree in Nursing. Minimum one to...Suggested
MJHS
New York, NY8 hours ago $223.8k - $313.1k
...Join our dedicated team and prioritize health first! The Medical Director utilizes their medical expertise to review health claims and engage in decision-making regarding patient care services. This role involves analyzing moderately complex to complex situations...SuggestedRemote workHumana
Austin, TX4 days ago$223.8k - $313.1k
...community that prioritizes health? As a Medical Director, you will utilize your medical knowledge and clinical experience to evaluate the... ...work week. In your position, you will be responsible for reviewing submitted medical records, analyzing complex clinical scenarios...SuggestedFull timeHumana
Sacramento, CA2 days ago$140k - $180k
...partnered with a large healthplan organization to find their next Utilization Management Director in Pasadena. Our client is a leading... ...like Anthem, SCAN, and Alignment Health. As the Utilization Review Director, you'll oversee 4 direct reports on the IPA side (UM...SuggestedFull timeRemote workAmi Network
Pasadena, CA2 days ago- ...Position Title: Appeal & Grievance Clinical Reviewer Location: Remote in AZ or surrounding state with compact license Assignment... ..., onbase and HRP (any or all). Similar skill set may be utilization management Description: Maintains a thorough...SuggestedFull timeWork at officeImmediate startRemote work
Spectraforce Technologies
Phoenix, AZ3 days ago $58.8k - $105k
...Connecting. Growing together. As a Behavioral / Mental Health Care Advocate you will be responsible for case management and utilization review of behavioral health and substance abuse cases. You'll have a direct impact on the lives of our members as you recommend and...SuggestedRemote jobMinimum wageFull timeWork experience placementWork at officeLocal area- ...HJ Staffing is urgently seeking a Medical Director of Utilization Management to join a leading Medicare Advantage Health Plan. This... ...ensuring the clinical integrity of inpatient and post-acute care reviews, evaluating medical necessity to support optimal outcomes and...Full timeRemote workMonday to Friday
HJ Staffing
United States1 day ago $248.5k - $373k
...expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools... ...primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and...Minimum wageWork experience placementLocal areaRemote workArizona Staffing
Phoenix, AZ8 hours ago- ...Job Description Guidehealth is seeking a Behavioral Health Utilization Management Medical Director (Psychiatry) to serve as a part-... ...commercial health plan. This role provides physician-level clinical review and consultative leadership across behavioral health services,...Bi-weekly payFull timeContract workTemporary workPart timeFor contractorsLocal areaRemote workWork from homeFlexible hours
Guidehealth
United States2 days ago $248.5k - $373k
...with a Fortune 4 industry leader. We are currently seeking a Utilization Management Medical Director to join our Clinical Performance team... ...for conducting hospital and post-acute utilization reviews for the state of California. The Medical Directors work with groups...Minimum wageWork experience placementLocal areaRemote workUnitedHealth Group
Los Angeles, CA1 day ago$60.2k - $107.4k
...global scale. Join us to start Caring. Connecting. Growing together. As a Behavioral Health Advocate, you will be responsible for utilization review of behavioral health and substance abuse cases. You'll have a direct impact on the lives of our members as you recommend and...Minimum wageFull timeWork experience placementWork at officeLocal areaRemote workMonday to FridayWeekday workUnitedHealth Group
United States4 days ago$60.2k - $107.4k
...is fully remote and requires Florida Residency As a Behavioral / Mental Health Care Advocate you will be responsible for utilization review of behavioral health and substance abuse cases. You'll have a direct impact on the lives of our members as you recommend and...Minimum wageFull timeWork experience placementWork at officeLocal areaRemote workHome officeUnitedHealth Group
United States16 hours ago$27.02 - $48.55 per hour
...LCSW, LPC, LMHC, LMHP****Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse... ...* Analyzes BH member data to improve quality and appropriate utilization of services* Provides education to providers members and their...Full timePart timeWork at officeRemote workFlexible hours$248.5k - $373k
**Optum is seeking a Medical Director for** **utilization management review** **to join our team. Optum is a clinician-led care organization that is changing the way clinicians work and live.** As a member of the Optum Care Delivery team, you'll be an integral part of...Minimum wageWork experience placementLocal areaRemote workWork from homeUnitedHealth Group
United States4 days ago$158.3k - $263.9k
...drive adoption. Measure & Optimize: Define KPIs for capability utilization and business impact, monitor performance, and identify... ...completing the online application process, please email: SeeYourself@cigna.com for support. Do not email ****@*****.*** for an update...Full timeLocal areaLiving Well Health Center
Santa Monica, CA2 days ago- ...The Warehouse Assistant also audits shelf counts for accuracy, reviews inventory for short-dated and expired product, and reports discrepancies... ...Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve...Work from homeShift work
Delaware Staffing
Newark, DE1 day ago $22 - $34 per hour
...Billing Team Lead Evernorth Remote job at Cigna. Bloomfield, CT. Billing Team Lead (Enrollment/Billing Lead Representative... ...strengthen billing quality. Drive continuous improvement by reviewing productivity, quality benchmarks, and trends; identifying opportunities...Hourly payContract workWork at officeLocal areaRemote workWork from homeCarlsbad Tech
United States8 hours ago- ...maximum value from our products and services. Your expertise will not only help us understand customer needs but also guide clients in utilizing our offerings to achieve their business goals. You will work closely with various departments, including sales, marketing, and...Remote work
Cigna Global Healthcare
Horsham, PA3 days ago - ...communities we serve. ~ Medical, Dental, & Vision Insurance through Cigna ~ Life Insurance ~403(b) Matching Retirement Fund ~... ...vital signs correctly. You bring knowledge of and correct utilization of good body mechanics. Required Qualifications Successful...Full timeLocal areaShift workDay shift
Beacon Health System
Three Rivers, MI8 hours ago - ...a clinical or surgical environment. The Clinical Educator will utilize their technical expertise to assist in installation and support... ...Services ~ Health and Wellness Programs and Events ~ Awarded 2024 Cigna Healthy Workforce Designation Gold Level Laborie...Flexible hours
Laborie Medical Technologies Corp
Los Angeles, CA4 days ago - ...divh2Job Title/h2pSummary:/ppThis position supports the Utilization Management (UM) workflows by providing administrative support and customer... ...Blue Card Claims escalations./liliAssist management with the review and creation of desk level procedures, acting as a subject...Contract workWork at officeWork from homeHome office
