- Cambia Health Solutions, Inc (Portland, OR)
- Behavioral Health Utilization Management Clinician Work from home within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create ... provide utilization management (such as prospective concurrent and retrospective review ) to best meet the member's specific healthcare needs and to promote… more
- US Tech Solutions, Inc. (Columbia, SC)
- …PREFERRED/NICE TO HAVE skill sets/qualities: I would love to have someone with prior insurance/ utilization review experience, but I know that is not very common. ... would have a diverse background with some knowledge of home health or DME as that is the type...any of the following in support of medical claims review and utilization review practices:… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …field needs with goal of enhancing processes. This will ensure coordination with home office Marketing tactics and field delivery on these tactics, ultimately ... creating increased utilization of the DSI portfolio in appropriate patients.Build strong...with stakeholders and cross-functional teams, agencies, and partners to review all congress initiatives, timelines and deadlines for content… more
- Novo Nordisk Inc. (San Francisco, CA)
- …academic and community HCPs Build and maintain relationships with HCPs and office staff by maximizing their time through planning, leveraging insights, and ... programs, local sponsorships, displays and exhibits, both in and out of office across multiple account types: academic institutions, physician offices, and alternate… more
- Fidelity TalentSource LLC (Boston, MA)
- …class core benefit experiences, including enrollment, onboarding, and plan utilization to deliver greater financial wellness for participants\u00A0 \u00A0\u00A0 ... career, empowering you to thrive at work and at home . Honored with a Glassdoor Employees Choice Award, we...not limited to a criminal, civil litigations and regulatory review , employment, education, and credit review (role… more
- Fidelity TalentSource LLC (Portland, OR)
- …through in-branch customer meetings, informative seminars, lead utilization , and client appreciation. The\u00A0Skills\u00A0You BringAll-encompassing brokerage and ... running branch infrastructure, including lobby and operational technology, back office processing, and quality assurance processes. How Your Work\u00A0Impacts\u00A0the… more
- Fidelity TalentSource LLC (Boston, MA)
- …strong sense of ownership and involvementAttention to detail, follow-through and utilization of judgment to problem solve, make decisions and take initiativeAbility ... in a continuously changing and fast paced environmentStrong Microsoft Office skills; Outlook, Word, PowerPoint, Excel and MS TeamsA...career, empowering you to thrive at work and at home . Honored with a Glassdoor Employees Choice Award, we… more
- Lennar Homes (Irving, TX)
- …the adoption of quality platforms, and leading engagements with leadership to review and enhance quality KPIs. Additionally, this role will introduce Data Quality ... to outline and implement support models, escalation paths.Lead the Quality Review Committee to ensure continuous improvement and enhancement of the organization's… more
- Fidelity TalentSource LLC (Boston, MA)
- …Additionally, you will develop strategies to accelerate adoption, enhance utilization , and improve proficiency in using Enterprise Technology products. By ... career, empowering you to thrive at work and at home . Honored with a Glassdoor Employees Choice Award, we...other week (all business days, M-F) in a Fidelity office . At Fidelity, we value honesty, integrity, and the… more
- Fidelity TalentSource LLC (Westlake, TX)
- …results\u00A0align associates across teams and product areas to ensure the best utilization of talent while also building learning opportunities and content to ... career, empowering you to thrive at work and at home . Honored with a Glassdoor Employees Choice Award, we...other week (all business days, M-F) in a Fidelity office . At Fidelity, we value honesty, integrity, and the… more
- Windstream (Vandalia, MO)
- …to ensure safe installation, meet demanding timelines and provide cost-effective utilization of materials and labor. Perform administrative work relating to projects ... effective technical communication skills, both verbally and written. Knowledge of Microsoft Office tools including Excel, Word, and Outlook Ability to be a… more
- Lennar Homes (St. Petersburg, FL)
- …on the Team Risk Analysis and Compliance: Conduct risk analysis and review loans for compliance with agency and investor guidelines.Decision Rendering and Timely ... per month for new loans and resubmissions.Automated Underwriting Systems Utilization : Utilize automated underwriting systems (Encompass, LPA, Desktop Underwriter) to… more
- Windstream (Lexington, KY)
- …to ensure safe installation, meet demanding timelines and provide cost-effective utilization of materials and labor. Perform administrative work relating to projects ... effective technical communication skills, both verbally and written. Knowledge of Microsoft Office tools including Excel, Word and Outlook Ability to be a… more
- American Honda Motor Co Inc (Torrance, CA)
- …carbon neutrality for all products and corporate activities and 100% utilization of renewable energy. The role requires collaborative efforts across multiple ... and services in EV charging, such as SmartCharge, V1G, V2X, HEMS ( Home Energy Management System), Hydrogen & Sustainability Solutions programs.Focusing on new… more
- Spectrum Billing Solutions (Skokie, IL)
- …in the most efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will ... clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and...+ Flexible work environment - You can work from home , hybrid or fully in office . +… more
- Centene Corporation (Madison, WI)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... role have the flexibility to work remotely from their home anywhere within the Central time zone **Position Purpose:**...the Central time zone **Position Purpose:** Performs a clinical review and assesses care related to mental health and… more
- CareFirst (Baltimore, MD)
- …detail can be shared during the interview process. Plans, organizes, and manages utilization review programs. Directs the utilization of referral services. ... expected to work a portion of their week from home and a portion of their week at a...Required. **Experience:** 8 years' Experience in a clinical and utilization review role. 3 years Management experience.… more
- Centene Corporation (Madison, WI)
- …for this role have the flexibility to work remotely from their home anywhere within the continental US. **Position Purpose:** Supervises Prior Authorization, ... Concurrent Review , and/or Retrospective Review Clinical ...ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources… more
- Point32Health (Canton, MA)
- …competence in directing operational compliance with CMS regulatory and NCQA, URAC ( Utilization Review Accreditation Commission) or DOI (Division of Insurance) ... the business processes and operations for all levels of utilization management review (ie, Precertification and Intake...transportation. + Must be able to work under normal office conditions and work from home as… more
- The Cigna Group (Franklin, TN)
- …Knowledge of applicable state and federal laws, URAC and NCQA standards, and utilization management + Excellent Microsoft Office skills, with PowerPoint and ... The Chief Medical Officer (CMO) Utilization Management will develop and manage efforts to...matters concerning clinical policy, quality management (QM), program development, review of UM cases, clinical criteria, and provider issues,… more
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