Anticipated End Date: 2025-10-31 Position Title: Manager, Genetic Review Job Description: Manager, Genetic Review... Carelon Medical Benefit Management Genetic Testing Hybrid 2: This role requires associates to be in-office 3 days per week...
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives... as a Registered Nurse 2+ years of experience in supporting UMR/ CCR 2+ years of experience as a Preservice Review / Prior...
-jurisdictional matters, and consulting on workflow organization for Technology Assisted Review (TAR)-leveraged protocols; privilege... Review Manager is responsible for simultaneously managing multiple client matters as well as developing and initiating new...
-jurisdictional matters, and consulting on workflow organization for Technology Assisted Review (TAR)-leveraged protocols; privilege... Review Manager is responsible for simultaneously managing multiple client matters as well as developing and initiating new...
’ experience in the medical field, managed care (utilization), medical coding, claims or related field. Maintain understanding...Job Description JOB TITLE Utilization Review Specialist I REPORTS TO Utilization Review Manager STATUS FT, Non-Exempt...
Director role. Responsible for timely and comprehensive medical review with concise documentation of pertinent facts...Job Category: Utilization Management Job Description: HealthPartners is hiring an RN Clinical Review Prior...
Director role. Responsible for timely and comprehensive medical review with concise documentation of pertinent facts...Job Category: Utilization Management Job Description: HealthPartners is hiring an RN Clinical Review Prior...
Director role. Responsible for timely and comprehensive medical review with concise documentation of pertinent facts...Job Category: Utilization Management Job Description: HealthPartners is hiring an RN Clinical Review Prior...
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives... to work in an effort that is seriously shaping the way health care services are delivered. As a Pre-Service Review Nurse...
-Service Review Nurse RN at UnitedHealth Group, you will make sure our health services are administered efficiently.... This is an inspiring job at a truly inspired organization. Ready to make an impact? ***Although this position is remote, applicants...
-Service Review Nurse RN at UnitedHealth Group, you will make sure our health services are administered efficiently.... This is an inspiring job at a truly inspired organization. Ready to make an impact? ***Although this position is remote, applicants...
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.... The Preservice Review Nurse RN is responsible for performing pre-service/prior authorization clinical coverage review...
criteria, referring those requests that fail review to the medical director for second level review and determination...You could be the one who changes everything for our 28 million members as a clinical professional on our Medical...
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.... The Preservice Review Nurse RN is responsible for performing pre-service/prior authorization clinical coverage review...
, hospital policies and external regulatory agencies, Peer Review Organization (PRO), Joint Commission, and payer defined... concurrent and retrospective utilization review to support and encourage the efficient and effective use of resources; promote...
services Experience working with EMRs (electronic medical records) Experience in managed care Experience conducting clinical...Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives...
Completes documentation review and requests additional information from prescribing physicians to establish medical necessity...Overview: Presbyterian is seeking a Clinical Pharmacy Review Specialist The Clinical Pharmacy Review Specialist...
to establish medical necessity and forwards to clinical pharmacists for second level review. Ability to apply critical thinking...Overview Presbyterian is seeking a Clinical Pharmacy Review Specialist The Clinical Pharmacy Review Specialist...
review experience at a Managed Care Organization or Health Plan required. Working knowledge of Medicaid and/or Medicare...RN- Utilization Review Nurse Inpatient *Full Time - 100% Remote Opportunity* Must reside within the New York Tri...
authorization or concurrent review within an insurance company and/or managed care organization. Experience leading a remote team... organization and monitoring of all medical services. Responsible for direct supervisory oversight of professional and front line...