- CVS Health (Frankfort, KY)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
- Molina Healthcare (Louisville, KY)
- …with multidisciplinary teams to promote Molina care model. * Adheres to utilization management (UM) policies and procedures. * May work collaboratively ... or have a compact RN license. The Care Review Clinician Inpatient Review BH will provide prior authorization for...for outpatient and inpatient services for the OH Medicaid behavioral health population. Strong post-acute level of care experience… more
- Molina Healthcare (Louisville, KY)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **MULTI STATE / COMPACT… more
- CVS Health (Frankfort, KY)
- …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more