Overview: NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate... for Utilization Management Registered Nurse: Develop, implement, and administer the quality assurance and utilization review...
, experience and growth. The Product Manager - Utilization Management and Prior Authorization will report to the Senior Director... products Requires expertise and thought leadership in Utilization Management and Prior Authorization solutions Experience...
in the UM Department. The Utilization Review Coordinator is responsible for executing the UR function, which includes the... implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan...
in the UM Department. The Utilization Review Coordinator is responsible for executing the UR function, which includes the... implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office... for Utilization Management Registered Nurse: Develop, implement, and administer the quality assurance and utilization review...
but saving them. Together. The Senior Manager, Inpatient Utilization Management (California LVN / RN Required) under the... direction of the Director of UM, is responsible for ongoing management of the UM Department, oversees clinical staff, ensuring...
Sr. Director, Quality and Utilization Management in developing, implementing, monitoring and updating quality improvement...Quality and Utilization Management Specialist What you will be doing: The Quality and Utilization Management...
but saving them. Together. **** MUST HAVE CALIFORNIA LICENSE*** *** Utilization Management Experience*** The Physician..., utilization and case management, or medical staff governance required. Preferred: Experience as a Physician Advisor...
Job Category: Revenue_Cycle Job Description: Under broad direction from the Centralized Utilization Management... Manager, is responsible for the hospital-wide Utilization Management Programs in a general acute care hospital which serves...
to policies and procedures. Communicates utilization plans to case management team. Evaluates concurrent and retrospective denials... in acute care setting required 2 years Case Management or Utilization Management experience preferred 1-2 years leadership...
and Supports (LTSS) Review Utilization Management program and staff under the supervision of the Director, LTSS Clinical Services... activities of the LTSS Review Utilization Management staff. Oversee staff performance with regard to medical necessity...
Role Overview: The After Hours Utilization Management Reviewer is scheduled to work non-traditional hours to provide... Thanksgiving and Christmas (rotating) Responsibilities: Conduct utilization management reviews by assessing medical necessity...
of two (2) years of prior experience in Utilization Management. Must possess a current, active, full, and unrestricted... precertification requests for medical necessity, referring to the Medical Director those that require additional expertise. Review...
POSITION SUMMARY: The Nurse Manager for Utilization Review and Clinical Appeal Management is responsible... for overseeing the daily operations of the Utilization Management (UM) and Clinical Appeal teams. This role ensures compliance...
benefits and the additional medical, community, or financial resources available. Provide utilization management (UM) services... to Large Case Reinsurance RN and Care Management team as appropriate. Assist Medical Director in developing guidelines...
benefits and the additional medical, community, or financial resources available. Provide utilization management (UM) services... to Large Case Reinsurance RN and Care Management team as appropriate. Assist Medical Director in developing guidelines...
benefits and the additional medical, community, or financial resources available. Provide utilization management (UM) services... to Large Case Reinsurance RN and Care Management team as appropriate. Assist Medical Director in developing guidelines...
benefits and the additional medical, community, or financial resources available. Provide utilization management (UM) services... to Large Case Reinsurance RN and Care Management team as appropriate. Assist Medical Director in developing guidelines...
benefits and the additional medical, community, or financial resources available. Provide utilization management (UM) services... to Large Case Reinsurance RN and Care Management team as appropriate. Assist Medical Director in developing guidelines...
requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis... Director, Case Manager, Preventive Services, Subrogation, Quality of Care Referrals, etc.). Participates in data collection...