Utilization Management Jobs in Des Moines, IA

Use your strengths as a Health Services Quality Coach for Wellmarks Federal Employee Program (FEP):   About the role: As an integral partner in upholding Wellmarks compliance and consistency within utilization management and case management processes you will be responsible for auditing the work of...

Use your strengths as a Health Services Quality Coach for Wellmarks Federal Employee Program (FEP):   About the role: As an integral partner in upholding Wellmarks compliance and consistency within utilization management and case management processes you will be responsible for auditing the work of...

Use Your Strengths at Wellmark as a Utilization Management Nurse! About the role: As a Utilization Management (UM) Nurse you will provide UM services transition of care and support to members and health care providers. You will utilize clinical knowledge and expertise to interpret and appropriately...

About the Opportunity: As an experienced M.D. or D.O. in adult acute care setting(s) you will use evidence-based decision making to perform inpatient case reviews that are timely and clinically appropriate. You will concisely effectively and consistently synthesize clinical information to document a...

OverviewFull-Time Days 8am-4:30pm Monday- FridayThe Care Coordinator integrates and coordinates the clinical care of individuals. Facilitates the interdisciplinary plan of care in order to meet multiple service needs promotes continuity through elimination of fragmentation of care/service and facili...

Anticipated End Date:Position Title:Utilization Management Rep IIJob Description:Utilization Management Representative IILocation: The selected candidate for this position must reside in Iowa.Virtual:This role enables associates to work virtually full-time with the exception of required in-person tr...

Use Your Strengths as a Case Management Nurse I at Wellmark! About the role: As a Case Management Nurse I you will serve as a key advisor who actively engages with members through a variety of channels to foster a caring and trusting level of connection in order to support their chronic and/or compl...

Eurofins Assurance offers third-party certification and compliance services across North America helping the Food Dietary Supplements Cosmetics OTC drugs industries meet the requirements of retailers brands and consumers facilitating international trade.  Eurofins Assurance certification also helps...

If not within a commutable distance to a Wellmark office you will be eligible to work remotely from your home location* with the expectation of the following travel to the Des Moines Iowa office:First 6 months/Onboarding: Every other week in Des Moines IA After 6 months: Quarterly in Des Moines IAAd...

Anticipated End Date:Position Title:LTSS Service Coordinator-Western IowaJob Description:LTSS Service CoordinatorLocation:Candidate would need to meet face to face with patients in and around the following counties. Candidate will be assigned a territory based on their location.ScottPolkIdaCherokeeP...

Anticipated End Date:Position Title:LTSS Service Coordinator-Western IowaJob Description:LTSS Service CoordinatorLocation:Candidate would need to meet face to face with patients in and around the following counties. Candidate will be assigned a territory based on their location.ScottPolkIdaCherokeeP...

OverviewFull-Time Weekend Package Days Friday- MondayThe Care Coordinator integrates and coordinates the clinical care of individuals. Facilitates the interdisciplinary plan of care in order to meet multiple service needs promotes continuity through elimination of fragmentation of care/service and f...

Appeals Pharmacist Ensure Fair Medication Access for PatientsA confidential managed care organization is seeking an experienced Appeals Pharmacist to review evaluate and process medication coverage appeals. This role is ideal for pharmacists who want to leverage their clinical knowledge and critica...

Remote Prior Authorization Pharmacist Work From Home in Managed CareA confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests ensure medical necessity and improve patient access to safe and effective therapies. This work-...

McKesson is an impact-driven Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights products and services that make quality care more accessible and affordable. Here we focus on the health happiness and well-being of you and those we serve we care...

As a Sr Medical Director you will be eligible to work remotely from your home location with the expectation of the following travel to the Des Moines Iowa office:First 6 months/Onboarding: Every other week in Des Moines IA After 6 months: Quarterly in Des Moines IAAdditional travel may be required t...