- Elevance Health (Chicago, IL)
- … clinical operations business inside a health plan or a UM /benefits management firm - Utilization management or clinical experience with post-acute care, ... for employment. **Director of Medical Mgmt, Post Acute Care UM ** + Job Family: MED > Licensed Nurse +...clinical reviews for a set of Post Acute Care Utilization Management solutions and complex cases such… more
- Elevance Health (Chicago, IL)
- …being performed. Preferred: -Leadership experience managing teams of physicians in a utilization management clinical operations business inside a health plan or ... a UM /benefits ...a UM /benefits management firm. -Proven experience leading change management ...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Elevance Health (Chicago, IL)
- …a check, or ask you for payment as part of consideration for employment. ** UM Medical Director - Cardiology** + Job Family: MED > Licensed Physician/Doctor/Dentist + ... clinical reviews. + The Medical Director typically has program management responsibilities including clinical policy development, program development/implementation, and… more
- Humana (Springfield, IL)
- …into concrete roadmaps that will generate tangible value for all stakeholders. Within the Utilization Management ( UM ) Strategy team, our goal is to enable ... and reducing unnecessary costs from the healthcare system. The Utilization Management Strategy Lead role...prior authorization and claims review, UM vendor management , analytics / reporting) + Knowledge of utilization… more
- Trinity Health (Maywood, IL)
- …preauthorization requests utilizing defined criteria. Collects, analyzes and communicates relevant utilization management information to insurers and third party ... our small but mighty team to guide and manage Utilization Review and Management for the Loyola...of the Director/Manager oversees the daily caseloads of the UR/ UM teams. This includes utilization review of… more
- Elevance Health (Chicago, IL)
- …you a check, or ask you for payment as part of consideration for employment. ** Utilization Management Representative** + Job Family: CUS > Care Support + Type: ... LOUISVILLE + IN, INDIANAPOLIS + IL, CHICAGO + MO, SPRINGFIELD **Description** ** Utilization Management Representative** **Location :** This is a remote position.… more
- Elevance Health (Chicago, IL)
- …send you a check, or ask you for payment as part of consideration for employment. ** Utilization Management Rep I (US)** + Job Family: CUS > Care Support + Type: ... insightful analytics to improve the delivery of care. The Utilization Management Representative I is responsible for...identification and data entry of referral requests into the UM system in accordance with the plan certificate. +… more
- Prime Therapeutics (Springfield, IL)
- …This role's responsibilities may include the management of drug formulary, Utilization Management ( UM ) programs, benefit design strategies, and other ... include clinical portions of internal and external client planning documents and/or UM program implementations and formulary management (planning P&T agenda and… more
- Kepro (IL)
- …the resources of the operational team(s) of our Illinois Quality Improvement and Utilization Management ( UM ) Contract. Your work will directly contribute ... innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra...capability to oversee the contract. + 3+ years of Utilization Management ( UM ) experience. +… more