- Merck & Co. (Boston, MA)
- …accelerating research and innovation.- We are seeking a passionate and knowledgeable Senior Specialist to join our Library team.- In this position, you will be ... linking our stakeholders with scientific and medical information resources. A successful Senior Specialist will have a drive for mastering a wide range of databases… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...quality of care/potential fraud issues are identified and documented per LA Care policy. High risk/high cost cases and… more
- HonorHealth (AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of ... of extended stay, outpatient observation, and inpatient stays and the utilization of ancillary services. Responsible for coordinating and conducting medical… more
- Hackensack Meridian Health (Hackensack, NJ)
- The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... population and Hackensack UMC. These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management , and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing… more
- Mount Sinai Health System (New York, NY)
- …Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt...EOW** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring… more
- Nuvance Health (Danbury, CT)
- …week) ; rotate one weekend per month Summary: The purpose of the Utilization Management Nurse is to support the physician, the interdisciplinary team, and ... and providing timely and accurate clinical information to payors. Utilization management provides clinically based first level...by the attending, and case does not meet criteria per first level medical necessity review, discuss case with… more
- UnityPoint Health (Cedar Rapids, IA)
- …+ Shift: 40 Hours Per Week + Job ID: 168048 Overview The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments ... + Area of Interest: Patient Care + FTE/Hours per pay period: 1.0 + Department: Adolescent Treatmt/Child...clinical outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management … more
- Amergis (Rancho Cordova, CA)
- …Week Amergis Healthcare is currently looking for qualified RN's with experience in Utilization Management . Apply today to learn more about the current ... opportunities! The Utilization Review Specialist is responsible for theassessment...or chest x-ray if applicable + Current Health certificate ( per contract or stateregulation) + Must meet all federal,… more
- St. Luke's University Health Network (Allentown, PA)
- …serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical ... SENSORY REQUIREMENTS: Requires sitting for up to 4 hours per day, 2 hours at a time. Standing for...+ Prefer minimum of 2-5 years' experience in case management and/or utilization management . +… more
- Hartford HealthCare (Willimantic, CT)
- …moment*. **Job:** **Non-Medical* **Organization:** **Rushford* **Title:** *Recovery Support Specialist (RSS) - Per Diem* **Location:** ... to provide support to patients based on personal experience, a Recovery Support Specialist performs many different tasks. The Recovery Support Specialist first… more
- Commonwealth of Pennsylvania (PA)
- Drug & Alcohol Case Management Specialist (Local Government) - Delaware County D&A Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5009526) ... Apply Drug & Alcohol Case Management Specialist (Local Government) - Delaware County...regular status, there may be opportunities for hybrid work, per the program offices' hybrid schedule. In order to… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the ... with clinical team partners. This position uses sound clinical judgement in the Utilization Management process and knowledge of regulatory requirements to make… more
- Veterans Affairs, Veterans Health Administration (Cincinnati, OH)
- Summary The Inventory Management Specialist Technical Career Field (TCF) Trainee is located at the Cincinnati VA Medical Center, in the Logistics Department. The ... may be available based on agency policy Position Description/PD#: Inventory Management Specialist (TCF) Trainee/PD99353TS and PD99353TS Requirements Conditions… more
- Alameda Health System (Oakland, CA)
- Care Management Specialist + Oakland, CA + Highland...in a health care field or one year in Utilization Management at a Medical Group or Health ... + HGH Care Coordination + Services As Needed / Per Diem - Day + Care Management ...field. Required Experience: One year experience in a case management specialist position in an acute care… more
- Elevance Health (Tampa, FL)
- **Medical Management Specialist I** The **Medical Management Specialist I** is responsible for providing non-clinical support to the Medical ... and determines appropriate area to refer or assign case ( utilization management , case management , QI,...work at an Elevance Health location at least once per week, and potentially several times per … more
- Trinity Health (Troy, NY)
- …that result from the clinical utilization reviews with the facilities Per Diem- Insurance Specialist to assist with authorizations for Substance abuse ... Specialist under general supervision, supports the administrative requirements for Utilization Management and works collaboratively with Utilization … more
- Veterans Affairs, Veterans Health Administration (Reno, NV)
- …Center in Reno, Nevada. The person in this position functions as the Emergency Management Specialist and is responsible for assisting the Emergency Management ... This is not a virtual position. Position Description/PD#: Emergency Management Specialist /PD99789S Relocation/Recruitment Incentives: Not Authorized Critical… more
- AON (San Francisco, CA)
- …and Office Leaders How this opportunity is different: + Collaborate with Account Specialist staff, Account Management team, and Client Service Delivery Leaders ... initiatives to ensure efficiency and build standard processes. + Educate assigned Account Specialist by leveraging training plans in client management , risk … more
- Wolters Kluwer (Dallas, TX)
- …efforts, prioritizing efforts and resources for assigned customer portfolio. + Ongoing Utilization Management + Oversee and analyze customer utilization ... Qualified applicants must be able to commute 2 days per week to a Wolters Kluwer US-based office **Supported...care. **Essential Duties and responsibilities** The Senior Customer Success Specialist plays a high-impact role in managing strategy and… more
