- Ventura County (Ventura, CA)
- Medical Management Nurse Senior - UM , CM /DM, &/or QA (Updated) Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4280743) Apply Medical ... Management Nurse Senior - UM , CM /DM, &/or QA (Updated)...Prevention, Utilization Management and tasks related to Healthcare Effectiveness Data and Information Set (HEDIS) as well as writing… more
- Elevance Health (Grand Prairie, TX)
- …Healthcare Clearinghouses (eg Availity, Change, etc.) + Experience with health plan operations (eg UM , CM , Claims, etc.) + Ability to 'hit the ground' running ... as part of consideration for employment. **Tech Program Manager ( UM / Referrals)** + Job Family: IFT > IT...results of testing and reviews continuous improvement plan with senior management. + Identifies team training and tool needs.… more
- Elevance Health (Columbus, OH)
- …SPO/PM (SAFE Product Owner/Product Manager) strongly preferred. + Healthcare/Prior Authorization/ UM / CM /DM experience strongly preferred. For candidates working ... or ask you for payment as part of consideration for employment. **Agile Product Owner Senior ** + Job Family: BSP > Business Support + Type: Full time + Date… more
- The Arora Group (Coronado, CA)
- …algorithms, CM software, and databases for community resources. + Integrate CM and utilization management ( UM ) and integrating nursing case management with ... beneficiaries. + Participate in medical provider meetings as dictated by the senior medical officer to provide accurate and up-to-date information on patients'… more
- The Arora Group (Bethesda, MD)
- …of case management services. + As required, enter approved metrics, patient data , and clinical progress notes into a prescribed database. + Conduct comprehensive ... and other family members, as warranted, and collects pertinent data from all involved health care agencies, medical providers...in obtaining services and support. + Serve as a senior nursing leader and advances the nursing profession in… more
- Blue KC (MO)
- …experience + Intermediate level keyboarding skills + Intermediate level knowledge of FACETS UM , CM and claims applications. + Experience in working with Health ... standards. Documents transplant authorization, issues authorization letters, and follows in FACETS UM system in accord with UM concurrent review guidelines.… more
- Synergy Healthcare Solutions (FL)
- …to the next level. The health care team may include physicians, health plan UM / CM Nurse, hospital discharge planners, referral coordinators, etc. + Consults with ... to online learning 24/7:** Our Learning Management System offers over 1,500 courses for senior care, health and human services industry. Use it for free to help… more