- Elevance Health (San Antonio, TX)
- …affordability, and personalized support throughout the consumer's treatment journey. **Title:** Utilization Management Representative II - Prior ... location. **Build the Possibilities. Make an extraordinary impact.** The Utilization Management Representative II -...(demographic) information from caller. + Refers cases requiring clinical review to a nurse reviewer ; and handles… 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 ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- Excellus BlueCross BlueShield (Utica, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …encourage you to apply! Job Description: Summary: This position supports the Utilization Management (UM) workflows by providing administrative support and ... and required. + Performs other functions as assigned by management . Level II (in addition to Level...Assist with all Blue Card Claims escalations. + Assist management with the review and creation of… more
- Medical Mutual of Ohio (OH)
- …of care and post-discharge follow-up care + Independently remains current on utilization management regulations, policies, and practices. + Promotes effective ... 3 years as a Registered Nurse with a combination of clinical and or utilization /case management experience, preferably in the health insurance industry. + Acute… more
- CommonSpirit Health (Phoenix, AZ)
- …a more just, equitable, and innovative healthcare delivery system. **Responsibilities** The Utilization Management Physician Advisor II (PA) conducts ... to all constituents. **Key Responsibilities** + Conducts medical record review in appropriate cases for medical necessity of inpatient...such as Joint Operating Committee (JOC), as requested by Utilization Management or Care Management .… more
- Prime Healthcare (Garden Grove, CA)
- … utilization review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone ... experience, education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/206176/ utilization - review -tech- ii /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityGarden Grove Hospital… more
- Prime Healthcare (Passaic, NJ)
- … utilization review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone ... business and office training; preferred. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/204216/ utilization - review -tech- ii social-work-services/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySt. Mary's… more
- Beth Israel Lahey Health (Boston, MA)
- …taking a job, you're making a difference in people's lives.** The Administrative Assistant II will support the Utilization Management team, and will work ... Data Analyst and the Authorization Administrator. This job will require good time management and multitasking at times (faxes, phones, entering info into EPIC). We… more
- Ventura County (Ventura, CA)
- …prepares the depreciation forecast for the Budget Development Manual. + Learns to review (Accountant I) or reviews (Accountant II ) fixed asset reconciliations ... inquiries from auditors and other agencies. + Learns to review (Accountant I) or reviews (Accountant II )...and prepare (Accountant I) or complies and prepares (Accountant II ) financial statements and utilization statistics for… more
- MTA (Brooklyn, NY)
- Assistant Transit Management Analyst I- II / Associate Transit Management Analyst (Elevators and Escalators) Job ID: 10130 Business Unit: New York City Transit ... Date Posted: Feb 26, 2025 Description Job Information : Title: Assistant Transit Management Analyst I- II / Associate Transit Management Analyst (Elevators and… more
- RTX Corporation (Marlborough, MA)
- …and test, rapid hardware development/builds and configuration and data management documentation. The **Rapid Hardware Solutions (RHS)** department within Mechanical ... mechanical design. We utilize Creo and Common Product Data Management (PDM) with tailored release processes for maximum cross-use...minimize cycle times and provide best value through the utilization of dynamic and agile processes. **RHS has an… more
- Amazon (Columbia, MD)
- …empowering them to achieve their objectives with greater efficiency, collaboration, and service utilization . A successful ADC Engineer II joining the team will ... and processes related to ADC operations and are a reviewer for others' work in this area. - You...of the UC organization, you'll support the development and management of Compute, Database, Storage, Internet of Things (IoT),… more
- MyFlorida (Tallahassee, FL)
- 68056425 - SENIOR MANAGEMENT ANALYST II - SES Date: Apr 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... for Health Care Administration Working Title: 68056425 - SENIOR MANAGEMENT ANALYST II - SES Pay Plan:...Develop and maintain quality control processes, such as peer review , to ensure that analyses performed by the section… more
- GCI Communication Corp (Anchorage, AK)
- …and utilization to meet business and operational needs. + Facilities Utilization & Performance: Regularly review network facilities utilization and ... PURPOSE OF POSITION: GCI's Core Network Administrator II provides expert-level support for local area networks (LAN), wide area networks (WAN), and internet-based… more
- Terracon (Baton Rouge, LA)
- …operations of a department including staff training, development, and performance review , utilization of equipment and facilities, safety oversight, quality ... or licensure in field of expertise. + Terracon Authorized Project Reviewer status preferred. **Exemption:** Exempt **Requisition ID:** 31279BR **Posting Title:**… more
- HCA Healthcare (Denver, CO)
- …personal growth, we encourage you to apply for our Provider Solutions Specialist II opening. We promptly review all applications. Highly qualified candidates ... invested over 156,000 hours volunteering in our communities. As a Provider Solutions Specialist II with HCA HealthOne you can be a part of an organization that is… more
- Prime Healthcare (Inglewood, CA)
- …EDUCATION, EXPERIENCE, TRAINING Required qualifications. 1. Knowledge in discharge planning/ utilization management /case management terminology and functions, ... Responsible for the coordination of the various activities of the Case Management Department under the direction of the assigned Case Manager/Social Worker in… more
- Prime Healthcare (Reno, NV)
- …Discharge Plan. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and ... Responsible for the coordination of the various activities of the Case Management Department under the direction of the assigned Case Manager/Social Worker assist… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …and maintains a variety of; prepares financial reports, statements and analysis for management review . + Performs assigned analysis and/or assists in complex ... to reimbursement concerns. + Applies principles of total quality management , team leadership, facilitates peer review activities...Ability to work with the various levels of internal management and external audiences. Level II -… more