• Utilization Review Case

    Covenant Health (Lewiston, ME)
    …experience in utilization review , discharge planning, social work case management, or Utilization Manager experience preferred. + Certification ... Summary The UR Case Manager conducts medical necessity reviews...or Advanced Beneficiary Notice (ABN) in collaboration with the Utilization Review Manager . + Documents… more
    Covenant Health (05/20/25)
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  • Medical Director- Medicare

    Elevance Health (South Portland, ME)
    …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians.… more
    Elevance Health (05/20/25)
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