- Universal Health Services (Chicago, IL)
- …in mental health/psychiatry preferred. Knowledge: Possesses knowledge of utilization review , insurance and managed care procedures. Current knowledge ... proof of authorization and denials communicated accurately in Midas. Interface with various managed care organizations and other payers to resolve issues related… more
- CVS Health (Columbus, OH)
- …IT platforms/systemPreferred Qualifications - Knowledge of Medicare/Medicaid - Utilization Review experience preferred - Managed care experience - ... purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our...in state of residence - Must have previous inpatient utilization review experience - Must be able… more
- UNC Health Care (Rocky Mount, NC)
- … Care in acute hospital setting + Working knowledge in Utilization Review , including managed care / commercial payers and governmental regulatory ... guidelines. Participates in ongoing educational opportunities to enhance health care team's knowledge of utilization review...to enhance health care team's knowledge of utilization review activities, including, at a minimum,… more
- Catholic Health (Lockport, NY)
- …+ Two years medical surgical nursing and/or job related experience + Preferred prior insurance / managed care / utilization review experience in the role of ... and Holiday Rotation Hours: 8:00a-4:00p, 9:00a-5:00p, 10:00a-6:00p, 11:00a-7:00p Summary: The RN Care Manager, Utilization Review / Transitions of Care… more
- Universal Health Services (Colorado Springs, CO)
- …an accredited college or university with a current Colorado RN license. Experience in utilization review , managed care , or determining appropriateness ... position is responsible for providing initial, ongoing, and systematic utilization review on all patients assigned by...with work hours to accommodate work volumes. Knowledge of utilization management and managed care … more
- CVS Health (Raleigh, NC)
- …(PowerPoint, Word, Excel, Outlook) Preferred Qualifications - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - ... ability to innovate and deliver solutions to make health care more personal, convenient and affordable. This Utilization... care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote… more
- CVS Health (Raleigh, NC)
- …years' experience Utilization Review experience -1+ years' experience Managed Care - Strong telephonic communication skills -Ability to exercise ... ability to innovate and deliver solutions to make health care more personal, convenient and affordable. This Utilization... care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote… more
- CVS Health (Austin, TX)
- …Psychologist, or RN with behavioral health background. Preferred Qualifications + 3 years Managed care / utilization review experience preferred. + Crisis ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- CVS Health (Frankfort, KY)
- …outside of the standard schedule based on business needs Preferred Qualifications: + Managed care / utilization review experience preferred + Experience ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- CVS Health (Baton Rouge, LA)
- …, including occasional rotating weekend and holiday schedules. Preferred Qualifications: + Managed care / utilization review experience preferred + ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Lancaster General Health (Lancaster, PA)
- …Board of Nursing. + Bachelor's degree in Nursing (BSN). + Knowledge of utilization review or managed care . + Care management experience in a ... care across the continuum (inpatient/outpatient/community) to assure appropriate utilization of clinical and community resources. + Oversees and guides the… more
- CVS Health (Lansing, MI)
- …skills which includes navigating multiple systems and keyboarding Preferred Qualifications: - Managed care / utilization review experience preferred - ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Trinity Health (Farmington Hills, MI)
- …years of nursing experience, to include two (2) years of utilization review /case management, managed care or comparable patient payment processing ... rejection, denial and appeal activities with Ministry Organization (MO) based Utilization Review /Case Management departments; + Reviews and understands … more
- St. Luke's University Health Network (Lehighton, PA)
- …health/crisis intervention experience required. Previous experience with case management/ utilization review and managed care models preferred. Please ... mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care… more
- Universal Health Services (Rosemead, CA)
- …with the treatment team/external case managers, authorizations, and utilization review with managed care organizations. This position provides ... disorders, trauma, substance use and LGBTQIA+ communities, to provide compassionate care to our diverse patients for our residential treatment facilities located… more
- International Medical Group (Indianapolis, IN)
- …Word and Excel. PREFERRED SKILLS + BSN Preferred + Minimum two years utilization review with a managed care or insurance company + Proficient verbal and ... of the use of health care services, procedures, and facilities for utilization review and /or /evacuation/repatriation. Work as a liaison between the… more
- Universal Health Services (Rosemead, CA)
- …direct input into the establishment of treatment plans, oversees utilization review with managed care organizations, and provides daily psychotherapeutic ... disorders, trauma, substance use and LGBTQIA+ communities, to provide compassionate care to our diverse patients for our residential treatment facilities located… more
- HCA Healthcare (Gainesville, FL)
- …and payors on a timely basis in accordance with the NFRMC Utilization Review Plan and managed care contractual agreements. . Performs other related ... , addressing all needs (ie, physical, psycho-social, financial). . Conducts utilization review , evaluates clinical information, and communicates findings to… more
- Dignity Health (Stockton, CA)
- …medical centers and agencies who serve as referral sources including utilization review and managed care companies. This position requires providing ... organization stands for showing respect for all people by providing excellent care . St. Josephs Behavioral Health Center is a licensed not-for-profit facility… more
- Trinity Health (Livonia, MI)
- …office staff, Patient Access, Medical Records/Health Information Management, Utilization Review /Case Management, Managed Care , Ancillary and Nursing ... Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc.), managed care contracts and coordination of benefits is required.… more