- CVS Health (Columbus, OH)
- …IT platforms/systemPreferred Qualifications - Knowledge of Medicare/Medicaid - Utilization Review experience preferred - Managed care experience - ... purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our...in state of residence - Must have previous inpatient utilization review experience - Must be able… more
- Catholic Health (Lockport, NY)
- …+ Two years medical surgical nursing and/or job related experience + Preferred prior insurance / managed care / utilization review experience in the role of ... and Holiday Rotation Hours: 8:00a-4:00p, 9:00a-5:00p, 10:00a-6:00p, 11:00a-7:00p Summary: The RN Care Manager, Utilization Review / Transitions of Care… more
- CVS Health (Raleigh, NC)
- …(PowerPoint, Word, Excel, Outlook) Preferred Qualifications - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - ... ability to innovate and deliver solutions to make health care more personal, convenient and affordable. This Utilization... care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote… more
- CVS Health (Columbus, OH)
- …1 holiday per year). Preferred Qualifications: - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - Strong ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- CVS Health (Harrisburg, PA)
- …- Holiday rotation required Preferred Qualifications: - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - Strong ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- CVS Health (Harrisburg, PA)
- …(PowerPoint, Word, Excel, Outlook) Preferred Qualifications: - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Lancaster General Health (Lancaster, PA)
- …Board of Nursing. + Bachelor's degree in Nursing (BSN). + Knowledge of utilization review or managed care . + Care management experience in a ... care across the continuum (inpatient/outpatient/community) to assure appropriate utilization of clinical and community resources. + Oversees and guides the… more
- CVS Health (Frankfort, KY)
- …outside of the standard schedule based on business needs Preferred Qualifications: + Managed care / utilization review experience preferred + Experience ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- CVS Health (Baton Rouge, LA)
- …, including occasional rotating weekend and holiday schedules. Preferred Qualifications: + Managed care / utilization review experience preferred + ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- CVS Health (Richmond, VA)
- …skills which includes navigating multiple systems and keyboarding Preferred Qualifications: - Managed care / utilization review experience preferred - ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Centene Corporation (Tallahassee, FL)
- …care setting or physician's office. Thorough knowledge of customer service, utilization review in a managed care environment and operation of office ... benefits including a fresh perspective on workplace flexibility. **Job Title:** Pediatrics Care Coordinator + Outreaches unable to reach (UTR) members on a quarterly… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …2 years in area of specialization, 2 years of Case Management/ Utilization Review experience **Other** Required: Managed Care knowledge Preferred: N/A ... and various internal departments **Job Title: Case Manager Concurrent Review ** **Location: Pearland Administrative Office** **Department:** **KCA Utilization … more
- St. Luke's University Health Network (Phillipsburg, NJ)
- …health/crisis intervention experience required. Previous experience with case management/ utilization review and managed care models preferred. WORK ... mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care… more
- St. Luke's University Health Network (Lehighton, PA)
- …health/crisis intervention experience required. Previous experience with case management/ utilization review and managed care models preferred. Please ... mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care… more
- CVS Health (Salt Lake City, UT)
- …setting such as ambulatory care or outpatient program- Managed care and utilization review experience preferred.- Crisis intervention skills ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- CVS Health (Columbus, OH)
- …our company expense reimbursement policy. Preferred Qualifications + Utilization Management review + Managed Care experience + Coding experience ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Universal Health Services (Rosemead, CA)
- …with the treatment team/external case managers, authorizations, and utilization review with managed care organizations. This position provides ... disorders, trauma, substance use and LGBTQIA+ communities, to provide compassionate care to our diverse patients for our residential treatment facilities located… more
- Universal Health Services (Rosemead, CA)
- …direct input into the establishment of treatment plans, oversees utilization review with managed care organizations, and provides daily psychotherapeutic ... disorders, trauma, substance use and LGBTQIA+ communities, to provide compassionate care to our diverse patients for our residential treatment facilities located… more
- Martin's Point Health Care (Portland, ME)
- …years clinical nursing experience + Utilization management experience in a managed care or hospital environment required + Certification in managed ... has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring… more
- Elevance Health (Atlanta, GA)
- …Continuous Quality Improvement skills and/or behavioral health, risk management, and/or utilization review in a managed care setting as well as process ... or virtual quality external audits such as NCQA, and External Quality Review Organizations, and prepares audits of required documents. + Prepares corrective action… more