- Humana (Santa Fe, NM)
- …of our caring community and help us put health first** Humana is seeking a Utilization Management (UM) Coordinator to join the Wisconsin Medicaid Market ... team. The UM Coordinator provides non-clinical support for policies and procedures related...for policies and procedures related to the administration of utilization management , ensuring the best and most… more
- Sunrun (Santa Fe, NM)
- …+ Own and develop partner or branch relationships including weekly/monthly reviews, utilization and workload management , process updates and identification and ... commitment to diversity, inclusion and belonging. **Overview** The Field Service Coordinator is responsible for coordinating effective execution of field service… more
- Magellan Health Services (Santa Fe, NM)
- …Magellan Credentialing criteria. 2+ years' post-licensure clinical experience. Experience in utilization management , quality assurance, home or facility care, ... Experience in analyzing trends based on decision support systems. Business management skills to include, but not limited to, cost/benefit analysis, negotiation,… more
- Highmark Health (Santa Fe, NM)
- …for the patient, and then creates the case (data entry) in Highmark's utilization management system for clinical review. Ensures all accurate information is ... documentation including verification of benefit eligibility. Build cases in the utilization management system. + Use knowledge of process and judgement to… more
- Sunrun (Santa Fe, NM)
- …and dispatch customer appointments in conjunction with Tech routes, schedules and utilization + Initiate and create tasks to complete further work required for ... within or across projects or cross functional teams with minimal direction from management + Meets all identified team and client performance metrics, goals and… more