Director is to ensure the utilization review activities are completed accurately and timely. This includes the precertification... a remarkable difference in the lives of those we serve. How you'll contribute The responsibility of the Utilization Review...
of clinical experience and/or utilization review experience. Current active, valid and unrestricted LPN/LVN license or RN license...Anticipated End Date: 2026-02-13 Position Title: Medical Management Clinician Job Description: Medical Management...
for utilization review/management. May be responsible for developing and implementing programs to improve quality, cost, and outcomes... years utilization management review experience preferred. Knowledgeable of Medicaid/Medicare policies and guidelines...
Discover Your Purpose with Us at Discovery Management Group! As Regional Director of Sales, you’ll play an essential... growth Lead training on sales strategies, CRM utilization (Aline), follow-up best practices, and conversion tracking Review...
Discover Your Purpose with Us at Discovery Management Group! As Regional Director of Sales, you’ll play an essential... growth Lead training on sales strategies, CRM utilization (Aline), follow-up best practices, and conversion tracking Review...
Preferred Qualifications: Bachelor's degree 2+ years of experience in utilization management or case management in a managed... and any associated case review and documentation. You'll enjoy the flexibility to work remotely * from anywhere within the...
, including support of variance analysis. Assist in the continued improvement, utilization and management of the capital... director and executives including progress towards meeting annual targets. Review monthly capital forecasts with each of the...
. Assists with concurrent and retrospective utilization review activities including denials and appeals. Works with physicians... to conduct peer review with payer medical director when indicated. Ensures clinical updates are provided to all insurance payers...
’s COOP instruction and as determined by the CCPA Director, be prepared to deploy toalternate site COOP locations to support..., including layout, color scheme, typography,and overall visual style for review by leadership and stakeholders. Responsive...
Preferred Qualifications: Bachelor's degree 2+ years of experience in utilization management or case management in a managed... and any associated case review and documentation. You'll enjoy the flexibility to work remotely * from anywhere within the...
Manager will be responsible for overseeing the planning, creation, and management of CCPA's English and foreign language... of Responsibility. Continuity of Operations: As specified by the Command’s COOP instruction and as determined by the CCPA Director...
and efficiently. Reports directly to: Director of Utilization Management. Responsibilities include: Admit new clients... admissions and discharge for both statistical and cost management purposes. Determine clients' requirements by completing intake...
effectively and efficiently. Reports directly to the Senior Director of Case Management in the Utilization Management Department... tracking of all hospital/nursing home admissions and discharge for both statistical and cost management purposes. Determine...
and will include weekends. The Medical Management Nurse will be responsible for review of the most complex or challenging cases... clinical, utilization review, or managed care experience; or any combination of education and experience, which would provide...