Search Results: 5,609 vacancies
...an opening for a Full Time physician/ Medical Director at James T. Vaughn Correctional Center... ...procedures, and medical disaster plans.
Manage referrals to outside healthcare... ...formulary for therapeutic regimens before utilizing non-formulary procedure.
Review all...
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...Opportunities: As a Behavioral Health Utilization Manager, you will be working with a diverse team... ...service delivery.
+ Reviews for medical necessity and appropriateness of services... ...clinical criteria to the Medical Director Review.
+ Identifies and escalates quality...
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...community and help us put health first
The Medical Director relies on medical background and... ..., and possible participation in care management. The clinical scenarios predominantly... ...teams focusing on quality management, utilization management, case management, discharge...
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...community and help us put health first
The Utilization Management Nurse 2 utilizes clinical nursing... ..., documentation and communication of medical services and/or benefit administration... ...+ Discussing cases with Medical Directors
+ Completing documentation for Quality...
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...community and help us put health first
The Medical Director actively uses their medical background... ..., and possible participation in care management. The clinical scenarios predominantly... ...teams focusing on quality management, utilization management, case management, discharge...
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...generate tangible value for all stakeholders.
Within the Utilization Management (UM) Strategy team, our goal is to enable members to... ...concepts, principles and practices (e.g., prior authorization, medical necessity, provider payment integrity, waste and abuse, etc...
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...health first
Humana Healthy Horizons in Ohio is seeking a Utilization Management Administration Coordinator 2 who contributes to... ...Preferred Qualifications
+ Proficient utilizing electronic medical record and documentation programs
+ Proficient and/or experience...
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...community and help us put health first
The Medical Director actively uses their medical background... ..., and possible participation in care management. The clinical scenarios predominantly... ...teams focusing on quality management, utilization management, case management, discharge...
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...a part of our caring community and help us put health first
The Supervisor, Utilization Management Pharmacy is a clinical pharmacist who leads a team of pharmacists who perform medical necessity reviews for prescriptions requiring pre-authorization. The Supervisor,...
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...United States
Want to be a part of our team?
The Principal Utility Program Manager ( PUPM ) builds relationships with utility providers to... ...company performance.
Employees receive paid time-off, medical, dental, and vision benefits, life and supplemental insurance...
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...community and help us put health first
The Medical Director’s primary responsibility is the review... ..., and possible participation in care management, with clinical scenarios arising from... ...clinical services
~ Experience in utilization management review and case management...
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...years of experience in NCQA Health Plan Accreditation and/or Utilization Management
+ Experience compiling NCQA File Review Universes and... ...outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan...
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...at Oracle in Dover, Delaware, United States
Product Manager – Utility Billing Service Delivery
Oracle’s Local Government GIU has... ...comprehensive benefits package which includes the following:
1. Medical, dental, and vision insurance, including expert medical...
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...our caring community and help us put health first
The Medical Director relies on medical background and reviews health claims. The... ...full time to the Indiana Pathways program to assist the Utilization Management, Care Management, and Quality departments’ staff to...
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...community and help us put health first
The Medical Director relies on medical background and... ...Qualifications
+ Knowledge of the managed care industry including Medicare Advantage... ...group practice management.
+ Utilization management experience in a medical management...
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...us put health first
The Corporate Medical Director relies on medical background and reviews... ...experience
+ Knowledge of the managed care industry including Medicare, Medicaid... ...Preferred Qualifications
+ Medical utilization management experience,
+ working with...
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...community and help us put health first
The Medical Director relies on medical background and... ..., and possible participation in care management. The clinical scenarios predominantly... ...teams focusing on quality management, utilization management, case management, discharge...
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...DUTIES AND RESPONSIBILITIES:
Manages the tactical execution of... ...staff.
Maintains integrity of medical records and other FMS... ...treatments in collaboration with the Director.
Plans, coordinates and... ...Responsible for efficient utilization of medication, laboratory, inventory...
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...Job Description
Job Description Utility Worker III
Are we RIGHT for you?
The word... ...and out of the workplace such as- full medical, dental, and vision benefits, 401k, paid... ...by fax to (***) ***-****or by mail to HR Manager, Middlesex Water Company, 1100 S Little Creek...
Local area
Gangs
...will never ask you for a credit card, send you a check, or ask you for payment as part of consideration for employment.
Utilization Management Representative II
+ Job Family: Customer Care
+ Type: Full time
+ Date Posted:Mar 08, 2024
+ Anticipated End Date:Apr...
Full time
Work from home
