- Nevada System of Higher Education (Las Vegas, NV)
- …Student Affairs (ASA) department. The individual serves as a confidential representative and liaison with senior management , faculty, system-wide administration ... conferences, travel, and standing meetings. Exercise good judgment for optimum utilization of the Vice Chancellor's time.Plan and organize special meetings and… more
- Tufts Medicine (Burlington, MA)
- … review and management . The position develops and leads the Utilization Management operations, strategy and implementation of the Utilization ... of Science in Nursing (BSN). 2.Massachusetts RN Licensure. 3. Current certification in case/ utilization management (ACM, CCM, CMAC) 4. Seven (7) years of UM/Case… more
- Elevance Health (Cerritos, CA)
- ** Utilization Management Representative II** **Location:** Virtual: This role enables associates to work virtually full-time in **CALIFORNIA** , with the ... an 8-hour shift between 8 am - 5 pm PST. The ** Utilization Management Representative II** is responsible for conducting service coordination functions… more
- Elevance Health (Woburn, MA)
- ** Utilization Management Representative II** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required ... Friday, an 8-hour shift between 8 am - 8 pm EST. The ** Utilization Management Representative II** is responsible for managing incoming calls, including… more
- Elevance Health (Mason, OH)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases… more
- Elevance Health (Las Vegas, NV)
- ** Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... 8:35 AM to 5:05 PM Pacific. Training hours may vary. The ** Utilization Management Representative I** is responsible for coordinating cases for… more
- Elevance Health (Louisville, KY)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases… more
- Brockton Hospital (Brockton, MA)
- … program that enhances the quality of patient care while optimizing resource utilization . Provides training to staff on case management methods and techniques. ... systems, plans and develops reports that clearly monitor all areas of utilization /case management . Provides data, guidance and input on the development… more
- University of Rochester (Rochester, NY)
- …discharge. Identifies problems that include but are not limited to pre-certifications, Utilization Management , Medicaid Pending, third party payer issues, and ... communication and follow-up with assigned area, Financial Assistance, Social Work, Utilization Management , Medicaid Enrollment & Outreach, patients, families,… more
- University of Rochester (Rochester, NY)
- …of Medicare and other payer regulations for the coordination of benefits. + Notify Utilization Management of clinical requests by third party payers. + Maintain ... Counseling, Medicaid Enrollment & Outreach, Financial Assistance, Registration and Insurance Management , Utilization Management , Social Work, Patient… more
- Luke Staffing (GU)
- …of clinical nursing experience is required. One year of previous experience in Utilization Management is required. Full time employment in a nursing field ... requirements of this position, it must be directly related to referral/ utilization management . + **Licensure:** Current, full, active, and unrestricted… more
- Boehringer Ingelheim (Chicago, IL)
- …along with further development of technical product knowledge is imperative. Effective utilization and management of internal and external resources is expected. ... records concerning activities; communicates timely, accurately and meaningfully with Management . Utilizes CRM tool and supporting analysis to plan activity,… more
- Cedars-Sinai (Beverly Hills, CA)
- …+ Acts as liaison coordinating administrative support activities including facilities management , patient billing, utilization management , quality ... **Job Description** The Senior Patient Service Representative - PACT (Float Pool) at Cedars-Sinai Medical...out-of-pocket expenses. A solid understanding of all Health Information Management (HIM) related activities is integral to the role.… more
- Cedars-Sinai (CA)
- …workflows. + As liaison coordinates administrative support activities including facilities management , patient billing, utilization management , quality ... **Job Description** The Senior Patient Service Rep is responsible for positive patient relations, accurate...plans and other departments. + Actively participate in lean management processes by detailing, monitoring and updating department specific… more
- Cedars-Sinai (Santa Monica, CA)
- …support activities to address physician and staff concerns such as facilities management , patient billing, utilization management , quality management ... **Job Description** The Lead Patient Service Representative functions as an administrative team lead for...ID** : 12629 **Working Title** : Lead Patient Service Rep - Santa Monica Orthopedic & Sports Medicine Group… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Skills and Experiences * 2+ years of managed care experience; eg case management /health coach, utilization management and/or auditing experience (may be ... and Blue Shield of Minnesota Position Title: RN Specialist Complex Care Case Management Location: Remote Career Area: Health Services About Blue Cross and Blue… more
- University of Rochester (Rochester, NY)
- …Medicare and other payer regulations for the coordination of benefits. + Notifies Utilization Management of clinical requests by third party payers. + Maintains ... considerations._ **Responsibilities:** GENERAL PURPOSE Manages and provides financial account management for all urgent, emergent, and pre-admission visits with a… more
- CVS Health (Belleville, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management ,… more
- CareFirst (Baltimore, MD)
- …role will focus specifically on optimizing end-to-end business processes within Utilization Management . **ESSENTIAL FUNCTIONS:** + Provide deep subject matter ... expertise in all areas of Utilization Management (UM), including pre-service, concurrent review,...of initiatives. Serve as the subject matter expert and representative for the clinical products team across corporate initiatives… more
- Texas Health Resources (Plano, TX)
- …also providing quality medical care. 5. Support effective patient throughput, utilization management , and compliant documentation. MEDICAL STAFF GOVERNANCE: 1. ... medical education programs. b. Assist the Medical Staff Office in the management of visiting medical students, Residents, Fellows, and observers. 3. Work with… more
