- Molina Healthcare (Fort Worth, TX)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... least 2 years health care experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …and co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: LVN/LPT $31.50-37.50 Per Hour ... and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician maintains knowledge of, participates in further training… more
- Molina Healthcare (NM)
- …healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies...such as LCSW, LPCC or LMFT (for Behavioral Health Care Review Clinicians only). Must be able… more
- Molina Healthcare (WA)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Molina Healthcare (CA)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Molina Healthcare (San Francisco, CA)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... health care experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Molina Healthcare (OH)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Molina Healthcare (Cedar Rapids, IA)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... health care experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Molina Healthcare (Los Angeles, CA)
- …other clinical programs. * Collaborates with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and ... * At least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed care , or equivalent combination of… more
- Molina Healthcare (NM)
- …to other clinical programs. * Collaborates with multidisciplinary teams to promote Molina care model. * Adheres to utilization management ( UM ) policies and ... At least 2 years of experience with inpatient concurrent review , prior authorization and managed care ; Acute care hospital experience with discharge planning… more
- Molina Healthcare (NM)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... good standing. **Preferred Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Molina Healthcare (Nampa, ID)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... good standing. **Preferred Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Molina Healthcare (Downers Grove, IL)
- …to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more
- Centene Corporation (Springfield, IL)
- …review process preferred. Experience working with providers and healthcare teams to review care services related to mental health and substance abuse ... experience in mental health settings and utilization management / review .** Department: PHCO BH UM supporting IL...weekend and holiday rotations **Position Purpose:** Performs a clinical review and assesses care related to mental… more
- US Tech Solutions (Chicago, IL)
- …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... objectives **Responsibilities:** + Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. +… more
- US Tech Solutions (May, OK)
- …. MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF ... objectives Responsibilities: . Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. .… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …* Certification in utilization management or a related field. * Experience in UM /CM/QA/Managed Care . * Knowledge of state and/or federal regulatory policies ... protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Care Mgr PreService & Retrospective Location: Remote Career Area: Health Services… more
- CareFirst (Baltimore, MD)
- … UM teams) by handling non-clinical tasks related to preauthorization functions, inpatient care , utilization review , care coordination and/or quality of ... of care that does not require intervention from a clinician including post-discharge monitoring, appointments and/or arranging services, enabling clinicians to… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... an Assistant Professor of Clinical in Pediatric Adolescent Gynecology on the Clinician Educator track will have clinical responsibilities within the Department of… more
- US Tech Solutions (RI)
- …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... **Job Description:** + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from… more