- STG International (Macon, GA)
- …War Veterans Home in Milledgeville, GA. JOB SUMMARY: The primary purpose of the LPN/ LVN is to provide direct nursing care to the residents. ESSENTIAL FUNCTIONS: + ... forms, reports, evaluations, studies, charting, etc., as necessary. + Periodically review the department's policies and procedures manuals, job descriptions, etc.,… more
- The Cigna Group (Birmingham, AL)
- …skills * Typing and computer knowledge- able to type 35WPM * Knowledge of utilization review requirements and procedures * Knowledge of current health care ... up calls which may include primary care physician and specialist appointment scheduling * Collaborates with the attending physician...**Experience:** * Current Licensure as a Registered Nurse or LVN /LPN, in the state of Alabama in good standing.… more
- Amergis (Orange, CA)
- The LPN/ LVN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service ... + Documents patient case information within a database system + Performs chart review /audits monthly or as needed + Participates in monthly case conferences by… more
- Integra Partners (Troy, MI)
- …do whatever it takes to get things done. PREFERRED SKILLS: + Certification in Utilization Review or Case Management + Experience with health insurance operations ... our Operations Training & Development team as an Operations UM Training Specialist , specializing in Utilization Management (UM) processes. The ideal candidate… more
- LA Care Health Plan (Los Angeles, CA)
- …patient care, such as ambulatory care, home care, or case management. OR experience in Utilization Review or Care Management will be considered in lieu of direct ... and/or disabilities in a case/care management environment. Preferred: Experience in utilization review , skilled nursing, home health, discharge planning,… more
- Select Medical (West Orange, NJ)
- …a physical rehabilitation setting preferred + Experience submitting prior authorizations and/or utilization review preferred. + Experience working with Excel and ... **Overview** **Kessler Institute for Rehabilitation** West Orange, NJ **Prior Authorization Specialist /Payor Relations Specialist ( RN , LPN )** **This is an**… more
- ManpowerGroup (Columbia, SC)
- …of medical claims review processes, medical necessity guidelines, and utilization review practices. + Proficiency in medical terminology, coding procedures, ... state of hire. **Job Description:** As a Medical Claims Reviewer/ Utilization Management Specialist , you will be responsible...services. + Ensure thorough documentation of each determination for utilization or claims review . + Review… more
- ManpowerGroup (Columbia, SC)
- …Reviewer" to join one of our Fortune 500 clients. **Job Summary** The Medical Review and Utilization Management Specialist is responsible for performing ... medical reviews using established criteria and conducting utilization management of professional, inpatient, outpatient, or facility benefits/services, as well as… more
- The Cigna Group (Bloomfield, CT)
- …skills. + Typing and computer knowledge- able to type 35WPM. + Knowledge of utilization review requirements and procedures. + Knowledge of current health care ... discharge follow up calls which may include primary care physician and specialist appointment scheduling. + Collaborates with the attending physician to achieve… more
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