- Tris Pharma (GA)
- …coaching, monitors sales representatives' performance and ensures resource utilization is aligned with company expectations.RESPONSIBILITIES Delivers sales ... coaching, leadership by example, mentoring and continuous motivation of sales representative team; Optimizes sales representative performance by: setting sales… more
- Elevance Health (Tampa, FL)
- RN Utilization Management Nurse Sr. (Medicaid-InPatient) JR130851 **Location:** Must be within 50 miles / 1 hour commute of Tampa or Miami, FL offices. This is ... to other areas of the business unit or as representative on enterprise initiatives. + Assigns and audits daily...Requires minimum of 5 years acute care clinical experience, utilization management or managed care experience; or… more
- Elevance Health (Indianapolis, IN)
- **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
- Elevance Health (Tampa, FL)
- ** Utilization Management Representative II** **Location:** Must live within 50 miles of a Florida PulsePoint. The ** Utilization Management ... benefits and/or eligibility information. + May act as liaison between Medical Management and internal departments. Responds to telephone and written inquiries from… more
- Elevance Health (Indianapolis, IN)
- **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
- TEKsystems (Daytona Beach, FL)
- Utilization Management Representative Remote Pay Rate: $20/hr Expected Start Date: 11/18 Schedule: M-F 8am-5pm Description: A person in this role will be ... Additional Skills & Qualifications: -2+ years of dental insurance experience - utilization management -prior authorization, referrals -front office dental… more
- UNC Health Care (Hendersonville, NC)
- …management referrals. Initiates appropriate social work referrals. + Performs utilization management assessments and interventions, using collaboration with ... **Description** Job Summary The Utilization Manager (UM) assesses new admissions, continued stay and discharge review cases for medical necessity, appropriate class… more
- Hawaii Pacific Health (Honolulu, HI)
- …Services, which provides Hawai'i Pacific Health and its affiliates essential population utilization and financial management support, analyses and modeling. The ... services in collaboration with the managed care services department including referral management , patient steerage, and claims auditing. As the Specialist, you will… more
- Brockton Hospital (Brockton, MA)
- … program that enhances the quality of patient care while optimizing resource utilization . Provides training to staff on case management methods and techniques. ... systems, plans and develops reports that clearly monitor all areas of utilization /case management . Provides data, guidance and input on the development… more
- Munson Healthcare (Traverse City, MI)
- … of Munson Healthcare serving as a resource to the Patient Care Management (PCM)/ Utilization Management (UM)/Clinical Documentation Integrity (CDI) staff to ... solid foundation, knowledge, and/or experience in the areas of utilization management , case management , clinical...and/or experience in the areas of utilization management , case management , clinical documentation integrity, quality… more
- Wolters Kluwer (Philadelphia, PA)
- …activities, branding & tailoring, pulling reports, and customer training. **Ongoing Utilization Management ** + Oversee customer utilization and ... Accounts** plays a lead role in managing and driving our customer's product utilization across the CE product portfolio. He/she serves as the lead Customer Success… more
- Cedars-Sinai (Los Angeles, CA)
- …workflows. + As liaison coordinates administrative support activities including facilities management , patient billing, utilization management , quality ... **Job Description** The Senior Patient Service Rep is responsible for positive patient relations, accurate...plans and other departments. + Actively participate in lean management processes by detailing, monitoring and updating department specific… more
- Cedars-Sinai (Beverly Hills, CA)
- …workflows. + As liaison coordinates administrative support activities including facilities management , patient billing, utilization management , quality ... More About What You Will be Doing** The Senior Patient Service Rep is responsible for positive patient relations, accurate telephone communication, appointment… more
- Cedars-Sinai (Los Angeles, CA)
- …hire and existing staff. + Coordinates administrative support activities including facilities management , patient billing, utilization management , quality ... members?** **Join our world-class team!** The Clinical Patient Access Representative is the primary clinical point of contact for...ID** : 4507 **Working Title** : Clinical Patient Access Rep - Patient Access Contact Center (Full-Time, 8 Hour,… more
- Molina Healthcare (Farmington, NM)
- …example, such meetings would occur to discuss and resolve issues related to utilization management , pharmacy, quality of care, and correct coding. * ... and contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability… more
- Highmark Health (Wilmington, DE)
- …drug policy, therapeutic alternatives, medication adherence strategies, Medication Therapy Management , utilization management , immunizations, specialty ... Delivery + Managed Care + Healthcare + Care Planning + Continuous Improvement + Utilization Management + Healthcare Management + Utilization Review… more
- Elevance Health (Tampa, FL)
- …equivalent and a minimum of 3 years acute care clinical experience or case management , utilization management or managed care experience; or any combination ... Job Description **Nurse Medical Management Sr.** **Preferred Location** : Florida. **This position...to other areas of the business unit or as representative on enterprise initiatives. **Ideal candidate **MUST** reside and… more
- Trinity Health (Farmington Hills, MI)
- …physicians and their office staff, Patient Access, Medical Records/Health Information Management , Utilization Review/Case Management , Managed Care, Ancillary ... time **Shift:** Day Shift **Description:** **POSITION PURPOSE** The Customer Service Representative handles customer inquiries in a timely, professional manner to… more
