Utilization Management Jobs in Douglas Qld

Employment Status:Full timeShift:Weekends Only (United States of America)Facility:1906 Belleview Ave SE - RoanokeRequisition Number:R152757 Case Management Team Lead - RN - Weekdays (Open) How Youll Help Transform Healthcare:The Case Management Lead RN serves as a team leader clinical resou...

Performs concurrent inpatient utilization review using InterQual criteria to determine if the request meets medical necessity criteria includingAdmission reviewsContinued stay reviewsTransitional care reviews (Skilled Nursing Facility Inpatient Rehabilitation Facility Long-Term Acute Care Hospital)R...

Help protect integrity strengthen compliance and improve how we serve our members.At Liberty Dental Plan our Internal Audit team plays a critical role in ensuring accuracy compliance and operational excellence across our organization. We are looking for a detaildriven analytical Sr. Internal Auditor...

DescriptionHealthPartners is hiring a Provider Relations and Contracts Service Specialist. This position is the key resource to assigned primary care groups specialty care groups hospitals and/or other medical providers (providers) participating with the organizations health plan networks. To maximi...

OverviewExisting YesCare employees working at the Alabama DOC Facilities do not need to apply. You will be contacted directly by a NaphCare representative.NaphCare is hiring an Administrative Assistant (AA) to join our team of medical professionals in the Limestone Correctional Facilityin Harvest AL...

DescriptionHealthPartners is hiring a Provider Relations and Contracts Service Specialist. This position is the key resource to assigned primary care groups specialty care groups hospitals and/or other medical providers (providers) participating with the organizations health plan networks. To maximi...

Company :Allegheny Health NetworkJob Description :JOB SUMMARYThis role requires a strong understanding of pharmacy benefits insurance processes and patient access procedures. Responsibilities include the coordination and administration of effective and efficient processing for pharmacy benefits prio...

Job Description SummaryWe are seeking an experienced board-certified MD or DO to serve as Regional Medical Director. The ideal candidate will have demonstrated leadership in value-based care models (ACOs MSSP Medicare Advantage commercial risk arrangements) strong clinical and operational judgment a...

City/StateVirginia Beach VAWork ShiftFirst (Days)Overview:Sentara Health Plans is hiring for a Behavioral Health Utilization Management Care Coordinator- Whole Person Care- Hybrid in the Peninsula Region!Position Status: Full-time permanent (40 hours/week)Standard Working Hours: 8 AM to 5 PM EST M-F...

OverviewPenn State Health Rehabilitation Hospital In partnership with Select MedicalPosition: Case ManagerLocation: Hummelstown PASchedule: FulltimeCompensation: Pay based on years of experience.Our Inpatient Rehabilitation Hospital is committed to providing exceptional and compassionate care to bes...

Anticipated End Date:Position Title:Director of Payor Contracting InfusionJob Description:Director of Payor Contracting InfusionLocation: This field-based role enables associates to primarily operate in the field traveling to client sites or designated locations as their role requires with occasio...

Anticipated End Date:Position Title:Director of Payor Contracting InfusionJob Description:Director of Payor Contracting InfusionLocation: This field-based role enables associates to primarily operate in the field traveling to client sites or designated locations as their role requires with occasio...

Inspire health. Serve with compassion. Be the difference.Job SummaryThe Prisma Health Physician is responsible for the provision of quality medical services to patients of Prisma Health-University Medical GroupAccountabilitiesEngages in the diagnosis prevention or treatment of disease defects or inj...

OverviewSelect Specialty HospitalCritical Illness Recovery Hospital (LTACH)Case ManagerFull Time: Monday-Friday 8-5pmRequires a current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist (RT) OR Medical Social Work (license per state guidelines).AndPrevious...

Inspire health. Serve with compassion. Be the difference.Job SummaryThe Prisma Health Physician is responsible for the provision of quality medical services to patients of Prisma Health-University Medical GroupAccountabilitiesEngages in the diagnosis prevention or treatment of disease defects or inj...

OverviewSelect Specialty HospitalCritical Illness Recovery Hospital (LTACH)Case ManagerFull Time: Monday-Friday 8-5pmRequires a current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist (RT) OR Medical Social Work (license per state guidelines).AndPrevious...

DescriptionRegistered Nurse (RN) Case ManagementJob Type: Full-Time 1.0 FTE or 80 hours/ppSchedule: 10-hour Day shifts Flexible Start Times (typically 7a-7:30a) Every 4th WeekendYour experience mattersUP Health System - Marquette is part ofLifepoint Health a diversified healthcare delivery network...

DescriptionRegistered Nurse (RN) Case ManagementJob Type: Full-Time 1.0 FTE or 80 hours/ppSchedule: 10-hour Day shifts Flexible Start Times (typically 7a-5:30p or 7:30a - 6p) Every 4th WeekendYour experience mattersUP Health System - Marquette is part ofLifepoint Health a diversified healthcare del...

Thank you for considering a career at Ensemble!Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solut...

Anticipated End Date:Position Title:Director of Payor Contracting SpecialtyJob Description:Director of Payor Contracting SpecialtyLocation: This field-based role enables associates to primarily operate in the field traveling to client sites or designated locations as their role requires with occas...