- Elevance Health (Meridian, ID)
- **Title: Utilization Management Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live ... within 50 miles of one of our PulsePoint locations. The ** Utilization Management Representative I** will be responsible for coordinating cases for… more
- Sedgwick (Boise, ID)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Representative - Liability **PRIMARY PURPOSE** **:** To process low level general ... physician filings and decisions on appropriate treatments recommended by utilization review. + Maintains professional client relationships. **ADDITIONAL FUNCTIONS… more
- HealthEdge Software Inc (Boise, ID)
- …Digital Health Management solutions have been shown to increase the utilization of preventive medicine services by 29%, reduce inpatient admissions by 17%, and ... **Overview** Company Overview: Wellframe is a digital health management platform that helps health plans offer convenient...reduce ER utilization by 9%. The platform meaningfully engages more people,… more
- Magellan Health Services (Boise, ID)
- …Healthcare-related field, or relevant experience in lieu of degree., Experience in utilization management , quality assurance, home or facility care, community ... care plan team which may include member, caregivers, member`s legal representative , physician, care providers, and ancillary support services to address care… more
- Magellan Health Services (Boise, ID)
- …and reports; provides accurate and timely financial recommendations to management for decision making purposes. + Develops sophisticated financial models. ... in cost of care. Differentiates impact of rate versus utilization variations. + Supports SBUs by providing information, responding...It has come to our attention that a false representative is contacting potential candidates and offering them work… more
- CBRE (Boise, ID)
- …a region, line of business or large, complex client. Includes the management of such functions as budgeting, forecasting, financial reporting, strategic planning and ... management reporting processes and work product. This position can...and approval. Plans and monitors appropriate staffing levels and utilization of labor, including overtime. Prepares and delivers performance… more
- CBRE (Boise, ID)
- …defined geographic region or account(s), including workforce planning, performance management , employee engagement, training and development and legal compliance. ... Primary business partners are first line supervisors and senior management , including managing directors. **ESSENTIAL DUTIES AND RESPONSIBILITIES** Provides HR… more
- CBRE (Boise, ID)
- …line GWS Segment Role type Full-time Areas of Interest Consulting, Project Management , Workplace Strategy Location(s) Anaheim - California - United States of ... and maintains processes to be followed by the function and defines portfolio management priorities for site, area and function planning of strategic activities for… more
- Nelnet (Boise, ID)
- … management of client accounts from contract receipt to everyday management , retention of business, increased utilization of products/services, and serving ... of Nelnet, Inc., provides payment technology, education services, and learning management solutions to education and faith-based organizations, serving more than… more
- Sharecare, Inc. (Boise, ID)
- …other members of the health care team to support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality ... the participants and their Primary Care Provider according to the disease management program intervention guidelines. An RN is supervised by an Operations Manager… more
- Trinity Health (Ontario, OR)
- …(pre-certifications, third-party authorizations, referrals) and contacts physicians and Care Management / Utilization Review personnel, as needed. + Obtains and ... routine payer or provider issues and escalates to Lead Patient Financial Services Representative . + Acts as a point of contact for assigned payers. + Maintains… more