- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization Review Specialist will perform prospective, ... (all benefits/incentives are subject to eligibility requirements). **Department** Clinical Utilization Management **Equal Employment Opportunity** CareFirst BlueCross… more
- Veterans Affairs, Veterans Health Administration (Fargo, ND)
- Summary The Supervisory Acquisition Utilization Specialist serves as a liaison and advisor on contract related services focusing on critical clinical and ... WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION The Supervisory Acquisition Utilization Specialist renders expert contract pre-award and post award expertise… more
- University of Michigan (Ann Arbor, MI)
- …withRHIT certificationOR Associate degree RN + At least 2-5 years of experience in Utilization Management , Appeals Management or Case Management + ... self-directed and work independently **Desired Qualifications + Experience with a case management / utilization management software program and EPIC (MiChart)… more
- McLaren Health Care (Flint, MI)
- We are looking for a part-time Intake Specialist , MI to join us in leading our organization forward. McLaren Integrated HMO Group (MIG), a division of McLaren Health ... case managers. Works with the PCP, the member and management to promote the delivery of quality services at...at the most appropriate and cost-effective setting. Monitors members' utilization patterns for identification of high-risk and under and… more
- St. Luke's University Health Network (Allentown, PA)
- …a patient's ability to pay for health care. The Surgical Review Specialist prospectively reviews, validates, and audits procedure code assignment in accordance with ... lost with feedback to respective departments + Conduct concurrent review with utilization review department for post op surgical cases with potential status issues,… more
- Mount Sinai Health System (New York, NY)
- **Job Description** MSHP seeks a Clinical Documentation Specialist who will support efforts to improve the overall quality and completeness of clinical documentation ... practices. They will work closely with physicians, Health Information Management and the Mount Sinai Health Partners team to...or more of the following, required: o Certified Coding Specialist (CCS) o Certified Risk Adjustment Coder (CRC) o… more
- Tufts Medicine (Burlington, MA)
- …setting (ICU, ED, Critical Care, strong Med/Surg Specialty) or equivalent case management , utilization review, denials management , or progressive leadership ... **Location: 100% Remote ** **Job Profile Summary** This role focuses on...other Quality indicators where indicated. 10. Collaborates with case management and utilization review team to ensure… more
- Vanderbilt University Medical Center (Nashville, TN)
- …**Responsibilities:** **Certifications:** Certified Coding Associate - American Health Information Management Association, Certified Coding Specialist - American ... Health Information Management Association, Certified Coding Specialist - Physician - American Health Information Management Association, Certified Outpatient… more
- Trinity Health (Columbus, OH)
- …Minimum of 5 years acute care medical or surgical experience required;** ** Utilization /Case Management , managed care, or Clinical Documentation and experience ... the multi-disciplinary team, including physicians, patient care services, case management , coding specialists and other healthcare disciplines regarding clinical… more
- CVS Health (Nashville, TN)
- …We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist . The position will be a part of a specialized team who will ... all sales presentations. + Servicing of existing members and inquiries related to utilization of their product, benefits, etc. + Cross selling applicable products to… more
- Anywhere Real Estate (Los Angeles, CA)
- The **Commercial** **Sales Specialist ** participates in and supports sales management efforts, by assisting the **Commercial Director** in a range of agent ... and detail-oriented + Must be proficient with technology tools and teaching agents on utilization of tools + Must have a valid Real Estate or Broker's license… more
- Trinity Health (Livonia, MI)
- …for new applications impacting multiple sites + Monitoring of RHM Enterprise circuit utilization + Review circuit utilization to identify sites may require ... upgrades. Position requires significant detail and effort around planning and change management . Expert technical skills are demanded in order to effectively respond… more
- Spectrum Billing Solutions (Skokie, IL)
- …mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist | Revenue ... flexibility? We offer flexible options to work in-office, hybrid remote /in-office, or to work 100% fully remote ... Utilization Review Specialist | ABA Utilization Management Specialist | ABA… more
- Western Area Power Administration (Montrose, CO)
- Summary The Energy Management and Marketing Specialist (EMMS) is responsible for the on-shift management of loads and resources, and marketing of resources ... required to be physically present in Montrose, Colorado.** Responsibilities The Energy Management and Marketing Specialist (EMMS) provides energy management … more
- DAI (Bethesda, MD)
- **Senior Lead Specialist , Public Financial Management ** City/Country Location Details **Bethesda, Maryland** Employment Status Job Type **Corporate** **Job** ... Innovations _Reports to:_ PFM Practice Director - Governance _Work Location:_ Bethesda or remote **Position Overview** The Sr. Lead Specialist is based in the… more
- Hospital Sisters Health System (HSHS) (Springfield, IL)
- Summary The Care Management Specialist , in collaboration with the Care Manager, assists in coordinating the utilization review and discharge planning tasks. ... certification is preferred. Physical Requirements: Administrative (https://hshs.icims.com/icims2/servlet/icims2?module=AppInert&action=download&id=250526&hashed=-655207489) The Care Management Specialist , in collaboration with the Care… more
- Health First (Melbourne, FL)
- *POSITION SUMMARY* The Case Management Support Specialist position is responsible for providing Quality/No Harm, Customer Experience, and Stewardship by ensuring ... **Clerical Support* **Organization:** **Holmes Regional Medical Center* **Title:** *Case Management Support Specialist - Per Diem* **Location:** *Florida… more
- Army National Guard Units (Colchester, VT)
- …TITLE 5 EXCEPTED SERVICE POSITION. This National Guard position is for a Logistics Management Specialist , Position Description Number T5121P01 and is part of the ... and users of the serviced database(s) in the absence of a Logistics Management Specialist . Administers the day-to-day database operation and maintenance of the… more
- Integra Partners (Troy, MI)
- …to join our Operations Training & Development team as an Operations UM Training Specialist , specializing in Utilization Management (UM) processes. The ideal ... industry standards, regulatory requirements, and best practices in clinical documentation and utilization management and update training documents as required +… more
- Green Cell Consulting (Quantico, VA)
- …The LM Specialist will: + Monitor the configuration, performance, and utilization of the Learning Management Systems to ensure continuous operations and ... Learning Management Specialist + + Full-time Company...may be required + Ability to work from a remote location + This position description outlines the general… more