Utilization Management Jobs in Douglas Qld

The OpportunityQuidelOrtho unites the strengths of Quidel Corporation and Ortho Clinical Diagnostics creating a world-leading in vitro diagnostics company with award-winning expertise in immunoassay and molecular testing clinical chemistry and transfusion medicine. We are more than 6000 strong and d...

The Manager Care Management is responsible for the daily management and organization of all activities and staff within the Care Management Department including care coordination case management discharge planning utilization management social work services and pre-admission case management. The Ma...

JOB SUMMARY/PURPOSEServe as an advocate for providers by ensuring they are informed supported and educated on Samaritan Health Plans procedures benefits policies and available provider toolsCoordinates and provides administrative support to the Network Contracting and Relations with internal dep...

The Social Worker LSW reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.Responsibilities:Psychosocial Assessment...

The Social Worker LCSW reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.A licensed masters-prepared social worke...

The Practice Success Manager serves as the operational owner of assigned provider relationships across Guidehealths partner networks ensuring successful engagement sustained performance and accountability at the practice level. This role functions as the primary operational and relationship partner...

The Physician Advisor (PA-Utilization Management) serves as the physician leader in matters relating to patient care. The PA will partner to reduce length of stay ensure appropriate use of level of care determinations (inpatient observation outpatient and other classifications as identified) support...

OverviewJOB SUMMARY: The Case Manager uses InterQual criteria to evaluate the appropriateness of admissions concurrent stay and readiness for discharge. She/he assures the correct level of care: critical telemetry acute observation for all patients. The Case Manager provides an efficient coordinated...

Solutions Architect I or II DOE - Healthcare ServicesHybrid (In office 3 days/week) within Oregon Washington Idaho or UtahBuild a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.Who We Are Looking For:Every day Cambias dedicated team of...

DescriptionNemours is seeking an Orthopedic Authorization Liaison to join our Nemours Childrens Health team in Wilmington DE.The Orthopedic Authorization Liaison is responsible for optimizing payment of services by obtaining and processing Elective Urgent and Emergent referrals and authorizations fo...

City/StateVirginia Beach VAWork ShiftFirst (Days)Provider SpecialtyUrgent CareOverview:The Urgent Care APP (NP or PA) is responsible for the provision of health care services to individuals families and/or groups who receive their care under the auspices of Sentara Medical Group (SMG). Health care s...

Lifekind Health is looking for an experienced Licensed Clinical Social Worker (LCSW) or Licensed Marriage & Family Therapist (LMFT) to join our team full-time. Deliver evidence-based psychological and behavioral health services to patients receiving care in a transdisciplinary pain management settin...

Anticipated End Date:Position Title:Genetic Counselor Review AssociateJob Description:Genetic Counselor Review AssociateGenetic Testing Utilization ReviewCarelon Medical Benefits ManagementVirtual: This role enables associates to work virtually full-time with the exception of required in-person trai...

Job Description: Summary:This position serves as the expert and leader for clinical and care management activities and overall coordination of Case and Disease Management specifically related to transplants and catastrophic conditions. This position oversees the clinical and administrative operation...

BandLevel 7Job Description Summary#LI-RemoteThis is a field-based and remote opportunity supporting a team in an assigned geography in West: California Oregon Washington Idaho Nevada Arizona Utah Colorado Montana Wyoming North Dakota South Dakota Minnesota Wisconsin. Ability to travel 60-70% over a...

Job Description: Summary:This position serves as the expert and leader for clinical and care management activities and overall coordination of Case and Disease Management specifically related to transplants and catastrophic conditions. This position oversees the clinical and administrative operation...

Remote Care Management Nurse (Future Opportunities)Work from home within Oregon Washington Idaho or Utah*Please be advised that this role is part of our candidate pool which allows us to identify and attract exceptional talent for future opportunities. Although we may not have immediate openings we...

SummaryWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but weve been part of the national landscape for more than seven decades with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South...

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...

DIRECTOR 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...