Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Providence caregivers are not simply valued – they’re inval...

Description We are hiring for Care Manager RN positions at Providence Alaska Medical Center in Anchorage, AK! Join us as a Care Manager to play a vital, hands‑on role during a transformational time in our department. Work at the top of ...

Description The Utilization Review (UR) Nurse has a strong clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports...

Hospitals on Incredible Health are actively hiring and accepting applications in the Jackson, MI area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encou...

Hospitals on Incredible Health are actively hiring and accepting applications in the Jackson, MI area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encou...

Hospitals on Incredible Health are actively hiring and accepting applications in the Jackson, MI area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encou...

Hospitals on Incredible Health are actively hiring and accepting applications in the Jackson, MI area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encou...

Hospitals on Incredible Health are actively hiring and accepting applications in the Jackson, MI area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encou...

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on ...

. Develop and implement product/process improvements. Support Integrated Product Teams (IPT) and participate in design reviews...

Title: IT Analyst – Ops Controls & Access Reviews Location: Remote Duration: Initial 6 months plus extensions Work.... Maintaining a continuous and strong security posture across all business and ISD IAM stakeholders via ongoing, proactive reviews...

to translate business needs into scalable IAM solutions Support and guide stakeholders in access reviews, role design...

, substance abuse, skilled nursing and rehabilitation for medical necessity; and all post claim or post service reviews..., wellness, chronic disease and Nurturing Together program. · Complete documentation for all reviews in Eldorado/Episodes...

, recertifications, peer-to-peer reviews, and appeals are completed accurately and within required timeframes. This leader will monitor... of precertifications, concurrent reviews, recertifications, peer-to-peer reviews, and appeals Supervise UR staff performance, workflow...

authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance...

. ESSENTIAL DUTIES 1. The UR Analyst gathers insurance, demographics, clinical information. They assure all clinical reviews... in a timely manner to third party request for concurrent and continued stay reviews and sharing of clinical information. 2. The...

reviews. Develops, administers, and manages the training of the appraisal review specialists, for both direct reports...

and medical necessity reviews of prior authorization requests in accordance with established guidelines and criteria Evaluate... in Prior Authorization (PA) or Inpatient (IP) reviews within an insurance/health plan environment Active LPN license...

of our Physician Advisory Team providing first level initial admission and continued stay case reviews. The Utilization Review... to application of the evidence-based criteria. Responsibilities: Perform initial admission and continued stay reviews utilizing...

Integrated Product Teams (IPT) and participates in design reviews. Represents the engineering community in the build through post... Integrated Product Teams (IPT) and participate in design reviews • Represent the engineering community in the build through post...