- Humana (Helena, MT)
- …Degree or BSN degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + ... help us put health first** We are seeking a Senior Accreditation Professional who will work in...on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming … more
- Evolent (Helena, MT)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... , you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Humana (Helena, MT)
- …a part of our caring community and help us put health first** The Senior Utilization Management Behavioral Health Professional utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Senior Utilization Management Behavioral Health Professional work… more
- Evolent (Helena, MT)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to… more
- Billings Clinic (Billings, MT)
- …and Central Sterile processing. This position is responsible for the overall management of the departments' daily operations to achieve quality improvement, fiscal ... for promoting internal and external customer satisfaction and for appropriate resource management . The Director shall utilize the principles of management to… more
- Evolent (Helena, MT)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Director you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent (Helena, MT)
- …Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Intermountain Health (Butte, MT)
- …+ Provide leadership and expertise to ensure that medical quality improvement and utilization management programs are carried out in clinical areas through the ... + Develop, implement and monitor medical policies and procedures (including case /disease management , utilization management and clinical programs) as they… more
- Cabinet Peaks Medical Center (Libby, MT)
- …operations of the emergency department, ensuring efficient patient flow and resource utilization . Management of staff: Scheduling, hires high quality personnel, ... to increase patient satisfaction. Planning: Aligns all work and resource management with CPMC mission, vision, values, goals and strategic initiatives. Actively… more
- Evolent (Helena, MT)
- …members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director. + Appropriately ... policies + Creates adverse determination notifications that meet all accreditation , State, and Federal criteria + Uses Plain Language...identifies potential cases for Care Management programs + Communicates appropriate information to other staff… more