- AltaMed Health Services Corporation (Montebello, CA)
- …Licensed Vocational Nurse. Minimum of 2 years of managed care experience in Utilization Management/ prior authorization required. A minimum requirement of a valid ... a calling that drives us forward every day. Job Overview The LVN Utilization Management Nurse (UM Nurse) will provide routine review of authorization requests from… more
- Curative HR LLC (Austin, TX)
- …team. This pivotal role will be responsible for overseeing and performing utilization reviews, prior authorizations, and making crucial medical necessity ... years of clinical practice experience. Minimum of 2-3 years of experience in utilization management, medical review, or prior authorizations within an insurance… more
- Legend Biotech USA, Inc. (Raritan, NJ)
- …inventory accuracy. This individual will also support the optimization and efficient utilization of the warehouse space. This individual will assist in regulatory ... activities to ensure inventory accuracy. Support the optimization and efficient utilization of the warehouse space.Assist in regulatory inspections, perform safety… more
- Novo Nordisk Inc. (San Diego, CA)
- …appropriate patients that would benefit in order to ensure early trial and utilization Generates advocacy for Novo Nordisk products and services by sharing approved ... engaging customers Intermediate computer skills required (Windows, Word, Excel); prior computer experience using sales data/call reporting software ideal knowledge… more
- Novo Nordisk Inc. (East Cleveland, OH)
- …sales and marketing resources to expand the breadth and depth of appropriate utilization Novo Nordisks products, consistent with label and company policy Analyze and ... experience required Intermediate computer skills required (Windows, Word, Excel); prior computer experience using sales data/call reporting software ideal Must… more
- Actalent (Chicago, IL)
- …In this role, you will utilize your clinical skills to conduct utilization management reviews, including prior authorizations, coverage exceptions, and quantity ... contracts evaluated every six months for extension. Responsibilities Conduct utilization management reviews, including prior authorizations, coverage exceptions,… more
- TrackFive (New York, NY)
- …to $2,900 per weekAbout The PositionJob Opportunity: Registered Nurse (Case Management - Utilization Review) Bronx, NY 10457 Duration: 13 Weeks Shift Details Days - ... can be completed online, ~$300 each)Learn More about PRI/SCREEN Preferred Experience Prior critical care experience Knowledge of CarePort, MCG, and/or InterQual … more
- Novo Nordisk Inc. (Boston, MA)
- …collateral development Achieve or exceed assigned sales objectives through effective utilization of all available resources, strategies and tactics Collaborates with ... make decisions, and operate your business activities with minimal supervision Prior computer experience using sales data/call reporting software preferred This… more
- Novo Nordisk Inc. (Olathe, KS)
- …and adapting to business priorities Educate HCPs to increase product utilization , optimize treatment, and align with evidence-based medicine and guidelines, while ... Ability to work independently in a field-based role is required Prior computer experience using sales data/call reporting software preferred Bilingual preferred… more
- TrackFive (Warren, MI)
- …and research, quality of practice, professional practice evaluation, resource utilization and environmental health. Strives to achieve optimal outcomes. Education:? ... take system action to implement agreed upon rate changes prior to the week the change becomes effective. It...reconciliation and issue inquiry/correction is performed by the supplier prior to the 45 days. No other forms of… more
- TrackFive (Boston, MA)
- …RequirementsRequirements: BSN, current Massachusetts RN license, 3 years of prior hospital Case Management plus Utilization Review experience ... required.About Patterns LLCPatterns is one of the leading service providers in the business process outsourcing industry. Patterns was incepted with the pursuit of being the one-stop solutions provider for all the business process outsourcing needs. For more… more
- TrackFive (Worcester, MA)
- …The PositionRequirements: BSN, current Massachusetts RN license, 3 years of prior hospital Case Management plus Utilization Review experience ... required.27644978EXPPLATAbout Patterns LLCPatterns is one of the leading service providers in the business process outsourcing industry. Patterns was incepted with the pursuit of being the one-stop solutions provider for all the business process outsourcing… more
- Sonder Health Plans, Inc. (Atlanta, GA)
- …for you to join us. Sonder Health Plans is looking for a full-time Utilization Management Nurse to make sure our health services are administered efficiently and ... that require additional clinical management support *Conducts initial review of prior authorization or pre-certification requests for determination of coverage for… more
- CenCal Health (Santa Barbara, CA)
- …CCM, CMCN, CPHQ, HCQM, CPUM, CPUR, or board certification in an area of specialty. Prior experience in Utilization Management (UM) within a managed care setting. ... $84,877 - $123,072 Annually Job Summary The Health Plan Nurse Coordinator - Adult Utilization Management (HPNC - Adult UM) is a Registered Nurse assigned to the … more
- AMN Healthcare (Pleasanton, CA)
- …HH setting to make UM decisions. Quality Coordinator exp CA LIC Preferred Qualifications Prior experience at Kaiser About Company At AMN Healthcare, we strive to be ... recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable. more
- Buckeye (Houston, TX)
- …with inventory accounting is preferred. Significant proficiency utilizing MS Excel. Prior utilization of trading software, Solarc RightAngle, is preferred. ... Assisting in the performance of monthly analyses, including budget-to-actual, prior -year variances and other key performance indicators for senior management… more
- Molina Healthcare (Long Beach, CA)
- …in Nursing Preferred Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge ... responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. Processes requests within… more
- Integrated Home (Hollywood, FL)
- …you come with: State licensure as a LPN or RN Minimum 2 years of prior experience in Utilization Management Strong knowledge of word processing and spreadsheet ... programs Comprehensive paid training program What will you be doing: As a Utilization Management Nurse, you will ensure that home health care services are… more
- Actalent (St. Paul, MN)
- …Your main role will be utilizing your clinical skills to complete utilization management reviews, including prior authorizations, coverage exceptions, and ... team of your peers and other pharmacy professionals. Responsibilities Conduct utilization management reviews independently. Participate in a team of pharmacy… more
- Optum (Brewer, ME)
- …and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform ... to perform duties Position requires extensive customer service and phone utilization , visual and auditory acuity, finger-wrist repetitive motion, and utilization… more
