- Humana (Little Rock, AR)
- …problem-solving skills, facilitation skills **Preferred Qualifications** + Experience with utilization review process + Experience with behavioral change, ... caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health...meet one of the following:** + Active unrestricted registered nurse license in the state of Virginia or obtain… more
- Humana (Little Rock, AR)
- …our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to support ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines and… more
- Veterans Affairs, Veterans Health Administration (North Little Rock, AR)
- …completion of more complex practices or procedures may be subject to closer higher-level review . GS-6, Licensed Practical Nurse : (a) Completion of at least one ... and record relevant] patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness… more
- Humana (Little Rock, AR)
- …of our caring community and help us put health first** The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, following ... services or forward requests to the appropriate stakeholder. The Pre-Authorization Nurse 2 work assignments are varied and frequently require interpretation and… more
- Evolent (Little Rock, AR)
- …be the single point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work can be divided into ... for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for utilization … more
- Highmark Health (Little Rock, AR)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
- Veterans Affairs, Veterans Health Administration (North Little Rock, AR)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules ... of medical clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical… more
- CVS Health (Little Rock, AR)
- …supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services. ... Responsible for initial review and triage of Care Team tasks. Identifies principle...for health care service delivery under the direction of nurse or medical director in the most appropriate setting… more
- Intermountain Health (Little Rock, AR)
- …anatomy and physiology. medical training such as medical assistant, certified nurse assistant, emergency medical technician. **Job Description Summary** Assesses and ... patients and/or patient's family, caregivers, and/or legal representatives socio-economic review and screening to support coordination of care. Plans interventions… more
- Evolent (Little Rock, AR)
- …years of direct clinical patient care + **Minimum one year of experience with Utilization Review (UM) in a managed care environment** + Cardiology and Oncology ... + Performs other duties as assigned. **Qualifications: Required and Preferred:** + Licensed registered nurse or LVN/LPN (current and unrestricted) + Minimum of three… more