- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …leadership, teamwork, and communication skills. ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical ... of candidates. Education Associates Degree preferred Minimum Work Experience Utilization Review experience preferably in a behavioral/psychiatric healthcare… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Nurse Specialist LVN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... that purpose. Job Summary The Customer Solution Center Appeals and Grievances Nurse Specialist LVN II is primarily responsible for the overall coordination of… more
- 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
- 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