Search Results: 31,383 vacancies
...issuance of adverse organization determinations. You will review for appropriate care and setting while working closely... ...CA LVN licensure required
* Two or more years of utilization review/utilization management experience in an HMO, MSO, IPA, or health plan environment...
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$41 per hour
...health solutions in the public sector.
Acentra seeks a Utilization Clinical Reviewer to join our growing team.
Job Summary
As a... ...inclusive and may be expanded to include other duties that management may deem necessary.
Required Qualifications/Experience...
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Full time
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...their journeys of recovery.
We are actively seeking a utilization review specialist to work in our corporate office in Pasadena, CA.... ...abuse benefits, community treatment resources, mental health managed care programs and company policies and procedures and criteria...
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...Description: Job Summary:Manages and plans high quality and accuracy Health Information Management Department related reviews such as, concurrent and retrospective pre-bill coding... ...Ability to demonstrate knowledge of and utilize health information management professional...
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Traineeship
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...Job Description
Job Description Job Description: Manager of Clinical Utilization Management - Denial Compliance
Location: Burbank, CA
Position... ...denial unit staff, managing daily tasks, performance reviews, and any necessary disciplinary actions.
2. Foster...
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...solutions in the public sector.
Position Overview:
As a Utilization Reviewer, you involves reviewing medical records against appropriate... ...expand to include additional duties deemed necessary by management.
Required Qualifications/Experience:
Minimum 2 to...
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Hourly pay
Part time
Local area
...Description: Job Summary:Develops, manages and directs the Utilization Management programs in a Service Area or a Medical Center. Develops and manages... ...admissions as well as concurrent and retrospective review of care. May also be responsible for other integrated functions...
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...moving forward.
Job Overview
Under the direction of the Director, Medical Management this position is responsible for overseeing and managing the day-to-day operations of the Utilization Management Department, health plan delegated activities, and medical...
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Learn more about us at cathaybank.com
GENERAL SUMMARY
Responsible for managing the loan review function, including detailed loan file and/or on-site reviews of all lending units using a risk-based approach to determine...
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Local area
Flexible hours
.... You can do all this and more at UCLA Health.
As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team... ...Pre-service Authorizations/Denial Letters
* Concurrent Review
* Continuity of Care
* Retro Claims
*...
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Monday to Friday
...Description
Job Title: Utilization Management Coordinator - Hybrid
Department: Health Services - UM
About the Role:
The Utilization... ...all UM processes such as pre-authorizations, retro reviews, Division of Financial Responsibilities and Health Plan contracts...
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Hourly pay
Immediate start
Work from home
...of network and appropriateness of treatment setting reviews within scope of licensure by utilizing appropriate medical policies and clinical guidelines... ...quality, cost effective care throughout the medical management process.
Educates the member about plan benefits and...
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...Responsibilities
Utilization Review (UR) Coordinator Opportunity.
Position: PRN (as needed)
This position is on-site and cannot... ...before applying, please contact Loretta Gaspar , HR Manager at: ****@*****.***
What do our current employees...
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$47.31 - $88 per hour
...The RN Float Case Manager and Utilization Review Nurse provides coverage for an RN Case Manager or RN Utilization Review Nurse. The RN Float Case Manager and Utilization Review Nurse is assigned to function in the role of either a RN Case Manager or RN Utilization Review...
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Full time
...potential to go FTE, hybrid role- ideally in a 2 hour radius from Rosemead
We are seeking a Technical Project Manager with experience supporting utility companies.
The Technical Project Manager is responsible for leading and delivering complex enterprise technology...
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Company Description:
Raftelis provides management consulting expertise to local governments and utilities so their organizations and communities can thrive. We’ve worked with more than 700 public agencies in the last year alone. We work in all areas of management consulting...
Local area
Work visa
Flexible hours
Night shift
...standards for associated medical groups.Key Responsibilities:1. Supervise licensed and non-licensed denial unit staff, managing daily tasks, performance reviews, and disciplinary actions.2. Collaborate effectively with physician reviewers, medical directors, and other...
Permanent employment
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...plays a critical role in our participant's journey and our Utilization Management team ensures we can provide timely, quality, compliant, and... ...operations within the designated UM team
Assist the team in reviewing prior-authorization requests for medical necessity and...
Hourly pay
Holiday work
...Insight Global is seeking a highly motivated Gas and Electric Utility Client Account Manager to join the team in the SoCal region. The successful... ...collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: .
Skills and...
...Description
Job Description Salary:
Position Title: LVN Utilization Manager
Department: Medical
Position reports to: Director of... ..., cost efficiency, and within compliance. By continuously reviewing and auditing patient treatment files, the utilization nurse...
