- Centene Corporation (Madison, WI)
- …knowledge of regulations, accreditation standards, and industry best practices related to utilization management + Works with utilization management ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks...applicable guidelines, policies, and procedures + Works with the senior management to develop and implement UM… more
- Evolent Health (Madison, WI)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Reviewer you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent Health (Madison, WI)
- …Be Doing:** As a Physician Clinical Reviewer you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more