• Senior Accreditation Utilization Management…

    Humana (Boise, ID)
    …UM Timeliness Monitoring and Reporting + Working knowledge using Power BI + Registered Nurse or Behavioral Health Licensed Professional. + Managed care, Medicaid ... + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Experience compiling NCQA File Review Universes and timeliness… more
    Humana (04/10/24)
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  • Staff Professional-Risk Mgmt

    Marriott (Boise, ID)
    …workers' compensation losses. The NCM is responsible for conducting first level Utilization Review and coordinates subsequent levels, if necessary, as required ... that may include multiple states. + Conducts first level utilization review per jurisdictional requirements. + Coordinates...informed **Education or Certification** + Must be a licensed registered nurse + Certification as an occupational… more
    Marriott (04/03/24)
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