• Utilization Management

    CVS Health (Boise, ID)
    …Qualifications** + Direct clinical experience in a hospital setting or prior Utilization Management experience. **Education** + If RN, Bachelor's degree in ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program for preauthorization for mental health services.… more
    CVS Health (10/04/24)
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  • Payment Integrity Clinician

    Highmark Health (Boise, ID)
    …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
    Highmark Health (09/27/24)
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