Utilization Management Jobs in Douglas Qld

As aPre-Auth Consultantyou will be a part of an Agile team to build healthcare applications and implement new features while adhering to the best coding development standards . Mandatory skills FACETS UM/Pre-Auth Configuration ITS/Authorization Routing Logic SQL & Rule Traceability Responsibil...

SummaryWe are currently hiring for a Managed Care Coordinator II Utilization Management to join BlueCross BlueShield of South this role as a Managed Care Coordinator II Utilization Management you will review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria b...

Registered Nurse (RN) Case Management / Utilization ReviewLocation: Hyannis MA 02601Duration: 27 WeeksShift: Day ShiftHours: 40 Hours Per WeekSchedule: Monday Friday 8-Hour ShiftsOn-Call: Rotating Weekend and Holiday Coverage RequiredWe are seeking an experienced Registered Nurse (RN) with a stro...

About CurativeCurative is building the future of health insurance with a first-of-its-kind employer-based plan designed to remove financial barriers and make care truly accessible: one monthly premium with $0 copays and $0 deductibles*. Backed by our recent $150M in Series B funding and valuation at...

Scope of work: Provides health information interacts and acts as a resource for providers for complex clinical situations to ensure appropriate use of preservice and concurrent acute medical and/or behavioral health care services. Assesses appropriateness of preservice and concurrent requests for ad...

Job Title:RN - Case Manager Location:Sanford FL Type:Direct Hire Full-Time Schedule:MondayFriday with Rotating Weekends Shift Times May Include:8:00 AM 4:30 PM9:00 AM 5:30 PM10:00 AM 6:30 PM11:00 AM 7:30 PMPosition Overview: Navitas Healthcare is seeking an experienced Case Manager RN to suppor...

DescriptionAre you an enterprising professional in behavioral health sales with business development skills and a marketing expert Join us as our Business Development and Marketing Director at Devereux League City! Why Join UsWork independentl...

Case Management Registered Nurse (RN)Location: Eureka CaliforniaContract Duration: 13 WeeksPosition Overview: Seeking an experienced Case Management Registered Nurse to support an acute care hospital setting. The ideal candidate will have strong acute care experience and be responsible for coordinat...

Most of what makes American healthcare expensive isnt medical care. Its the machinery wrapped around it: middlemen taking a cut fraud nobody stops and billing systems designed to fight over payment instead of deliver care. The result is higher premiums denied claims surprise bills and a system patie...

Employment Type:Full timeShift:Day ShiftDescription:Full time RN Case Manager in the inpatient setting at Trinity Health Grand Rapids HospitalThis position is for a RN Case Manager at Trinity Health Hospital in Grand Rapids MI. Trinity Health is a Magnet Designated Hospital! This role will provide c...

DescriptionService Utilization SpecialistJoin our team at FSS and enjoy comprehensive benefits including but not limited to:Tuition ReimbursementHealth InsuranceDental InsuranceVision InsuranceLife InsuranceWell-Being ProgramPaid Time Off (PTO)Bereavement Leave12 Paid HolidaysFlexible Spending Accou...

Department:13546 Enterprise Revenue Cycle - Harrisburg NC Arrival Emergency DepartmentStatus: Part timeBenefits Eligible:NoHours Per Week:0Schedule Details/Additional Information:VariousPay Range$20.80 - $31.20Major Responsibilities:Responsible for performing all job duties in a way that conforms to...

Anticipated End Date:Position Title:Plan Performance Medical Director- Missouri Medicaid MarketJob Description:Plan Performance Medical Director- Missouri Medicaid Market Location: This role enables associates to work virtually full-time with the exception of required in-person meetings providing ma...

The Project Manager Clinical Transformation (PM) supports the end-to-end coordination and execution of cross-functional initiatives focused on clinical operations enablement workflow modernization regulatory readiness operational adoption and technology implementation across Healthfirst. The PM is r...

CUSTOMER CAREONSITEEMPLOYMENT TYPE: Full-Time ExemptAbout Umpqua HealthAt Umpqua Health were more than a healthcare organizationwere a community-driven Coordinated Care Organization (CCO) dedicated to improving the health and well-being of individuals and families throughout Douglas County Oregon. W...

About CurativeCurative is building the future of health insurance with a first-of-its-kind employer-based plan designed to remove financial barriers and make care truly accessible: one monthly premium with $0 copays and $0 deductibles*. Backed by our recent $150M in Series B funding and valuation at...

At Zelis we Get Stuff Done. So lets get to it!A Little About UsZelis is modernizing the healthcare financial experience across payers providers and healthcare consumers. We serve more than 750 payers including the top five national health plans regional health plans TPAs and millions of healthcare p...

General Sales Manager (GSM) AutomotiveCharleston South CarolinaMcDaniels Auto GroupMcDaniels Auto Group is seeking an experienced results-driven General Sales Manager (GSM) to lead and develop our sales operations in Charleston South Carolina.Relocation Assistance Available for Qualified CandidatesT...

The Clinical Documentation Improvement (CDI) program at UI Health Care has an opening for a full-time CDI Quality Analyst. The primary purpose of Clinical Documentation Improvement (CDI) is concurrent review of the medical record to increase the accuracy clarity and specificity of provider documenta...

Job Description: Summary:Conducts case management program activities in accordance with departmental corporate NYS Department of Health (DOH) Centers for Medicaid & Medicare Services (CMS) Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards as a...