- Evolent Health (Santa Fe, NM)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... , you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Magellan Health Services (Albuquerque, NM)
- …appropriate for complex case management and timely completion of all utilization management activities. Involvement in the development of case management ... plans. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality of patient care,… more
- CenterWell (Santa Fe, NM)
- …payer contracts + Monitor the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation + Policies and ... and many of the delegation oversight listed above + Home infusion Therapy Accreditation and Pharmacy accreditation for infusion nursing services, NABP, URAC,… more