Utilization Management Nurses and associated programs and processes, as directed by the Senior Manager, Patient Review and Intake..., Patient Review & Intake Services or Manager, Utilization Management to: Manage team responsible for completing utilization...
experience preferred Work experience in utilization management/review in a healthcare/MCO setting preferred Knowledge.... Discover more about us at www.amerihealthcaritas.com. Responsibilities: The Utilization Management Tech functions under the...
Job Summary: Interacts with the Interdisciplinary staff to complete the process of utilization management. Education... required with prior experience preferred in utilization management. Knowledge of managed care practices preferred with minimum of five...
Role Overview: The After Hours Behavioral Health (BH) Utilization Management (UM) Reviewer is scheduled to work non... and providers to collect all information necessary to perform a thorough medical necessity review. It is within the Reviewer...
in alignment with HealthPartners leadership characteristics. To ensure optimal performance on utilization review performance... to Utilization Review Maintains a working knowledge of Medical Policy, Behavioral Health (Health Plan) and Case Management...
in alignment with HealthPartners leadership characteristics. To ensure optimal performance on utilization review performance... to Utilization Review Maintains a working knowledge of Medical Policy, Behavioral Health (Health Plan) and Case Management...
experience preferred Work experience in utilization management/review in a healthcare/MCO setting preferred Knowledge.... Discover more about us at www.amerihealthcaritas.com. Responsibilities: The Utilization Management Tech functions under the...
in alignment with HealthPartners leadership characteristics. To ensure optimal performance on utilization review performance... to Utilization Review Maintains a working knowledge of Medical Policy, Behavioral Health (Health Plan) and Case Management...
Description The Utilization Review/Management (UR/UM) Nurse position will work in in our UR/UM department. An overview of the work...Claims Utilization RN Department: Recruitment Employment Type: Full Time Location: MedTrust - Oklahoma City...
, and discharge planners in utilization tracking, care coordination, and monitoring to ensure care is appropriate, timely and cost... reimbursement, CEU credits, and advancement opportunities What You Will Do: Conducts comprehensive review of all components...
and some holidays. General Summary Under general supervision, provides utilization review and denials management for an assigned... utilization review for all patient populations, using nationally recognized care guidelines/criteria relevant to the payer. 2...
and some holidays. General Summary Under general supervision, provides utilization review and denials management for an assigned... utilization review for all patient populations, using nationally recognized care guidelines/criteria relevant to the payer. 2...
JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential... RESPONSIBILITIES: Performs utilization review of outpatient and ancillary services as well as inpatient and post-acute services when...
, utilization review, and/or medical management. Experience with oversight and development of team workflows, and educational...Description : What to expect The Utilization Management & Appeals Clinical Supervisor will provide clinical...
, and discharge planners in utilization tracking, care coordination, and monitoring to ensure care is appropriate, timely and cost... reimbursement, CEU credits, and advancement opportunities What You Will Do: Conducts comprehensive review of all components...
, and discharge planners in utilization tracking, care coordination, and monitoring to ensure care is appropriate, timely and cost... reimbursement, CEU credits, and advancement opportunities What You Will Do: Conducts comprehensive review of all components...
, and discharge planners in utilization tracking, care coordination, and monitoring to ensure care is appropriate, timely and cost... reimbursement, CEU credits, and advancement opportunities What You Will Do: Conducts comprehensive review of all components...
, and discharge planners in utilization tracking, care coordination, and monitoring to ensure care is appropriate, timely and cost... reimbursement, CEU credits, and advancement opportunities What You Will Do: Conducts comprehensive review of all components...
for utilization review activities including admission reviews, admission denials, continued stay reviews, continued stay denials... as a leader of positive change. The Care Management, Care Coordinator, Utilization Management is a member of the healthcare team...
. As we continue to build something great, we are looking for a Utilization Case Manager to assess plans and coordinate optimal...-approved clinical criteria for utilization management decisions; reviewing member’s medical record; communicating with member...