- Humana (Santa Fe, NM)
- …Degree or BSN degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Experience compiling NCQA File Review ... 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. + Detailed… more
- Evolent Health (Santa Fe, NM)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Reviewer 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
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …Clinic. Responsibilities VA Careers - Social Work: https://youtube.com/embed/enRhz\_ua\_UU Program Management Develops a system to identify SCI patients served by ... admitted and discharged within the medical center, and to review utilization of laboratory, pharmacy, inpatient, and outpatient resources. Establishes performance… more