Utilization Management Jobs in Douglas Qld

Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services this position you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical Necessity Criteria respective to various Health Plans.This position...

City/StateSuffolk VAWork ShiftFirst (Days)Overview:OverviewReporting to the division president and as a member of the division leadership team the VP Chief Medical Officer is accountable for the clinical performance improvement including the promotion of clinical appropriateness the reduction of unw...

Overview:**5000 Net Sign-on Bonus** New employees only40 hours per week Monday - Friday 8am - 5pmSalaried Nursing position. Full-time benefits.Family Experience: For Kids Website: Job Description Summary:Ensures the provision of quality patient care in the appropriate setting through care coordinat...

ENL Case ManagementCompensation range:$58.56 - $79.06Your rate of pay will be based on applicable experienceShift: Days Days off: Variable one weekend shift per week is required Hours per pay period: 60S...

OverviewOpportunities for you!Consecutively recognized as a top employer by Forbes and in 2025 by NewsweekFree Continuing Education and certificationTuition reimbursement educationprogramsand scholarshipsVacation time starts building on Day 1 and builds with your seniorityFree money toward retiremen...

Site: The Brigham and Womens Hospital Inc.Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and community service st...

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...

2200 River Plaza Dr Sacramento CA 95833 Description: Job Title: Authorization Coordinator I Location: 100% Remote Sutter Health CAOP Authorization Schedule: Remote AM shift 5x8-hour days 6 months from onboarding date Contract full-time non-exempt Requirements: HS diploma or equivalent edu...

Job Location: 415 Patterson Avenue Santa Barbara CA 93111 Description: Job Title: Authorization Coordinator I Location: 100% Remote Sutter Health CAOP Authorization Schedule: Remote AM shift 5x8-hour days 6 months from onboarding date Contract full-time non-exempt Requirements: HS diploma...

DescriptionTHE POSITIONUnder general direction of the Health Care Plan Administrator responsible for managing the daily operations of the Quality Assurance Utilization Management and Case & Disease Management departments within the Ventura County Health Care Plan.The Director of Health Services - Ve...

DescriptionHealthPartners is hiring an RN Medical Coverage Policy Consultant. The Consultant is responsible for the development maintenance review and implementation of medical policies/criteria which support clinical decision-making coverage for services that are rooted in scientific evidence prove...

Our CompanyAdoration HealthOverviewThe Patient Care Manager Assistant supports the Clinical Manager in coordinating staff to ensure continuity and quality of care for assigned home health patients. Ensures team members are informed skilled and deliver care efficiently in compliance with physician or...

What Awaits You:Opportunities for Career Growth Build a meaningful career with access to professional development mentorship and advancement pathways.Collaborative and Inclusive Environment Work alongside a diverse team of professionals who value mutual respect innovation and teamwork.Comprehensiv...

Hours:Shift Start Time:VariableShift End Time:VariableAWS Hours Requirement:10/40 - 10 Hour ShiftAdditional Shift Information:10 hour shifts between the hours of 7 am and 7 pmWeekend Requirements:As NeededOn-Call Required:NoHourly Pay Range (Minimum - Midpoint - Maximum):$46.110 - $59.500 - $66.650T...

Hours:Shift Start Time:VariableShift End Time:VariableAWS Hours Requirement:8/40 - 8 Hour ShiftAdditional Shift Information:up to 8 hour shifts between the hours of 7 am and 7 pmWeekend Requirements:As NeededOn-Call Required:NoHourly Pay Range (Minimum - Midpoint - Maximum):$50.720 - $65.450 - $73.3...

OverviewNaphCare is hiring an Administrative Assistant (AA) to join our team of medical professionals in the Arizona Department of Corrections - Winslowin Winslow AZ.As a Correctional AA you will work alongside correctional officers and other medical professionals who provide care to the individuals...

About Blue Cross and Blue Shield of MinnesotaAt Blue Cross and Blue Shield of Minnesota we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate...

Hours:Shift Start Time:8 AMShift End Time:4:30 PMAWS Hours Requirement:8/40 - 8 Hour ShiftAdditional Shift Information:Weekend Requirements:No WeekendsOn-Call Required:NoHourly Pay Range (Minimum - Midpoint - Maximum):$25.550 - $31.860 - $35.680The stated pay scale reflects the range that Sharp reas...

IntroductionTHIS IS A NEW ASSEMBLED EXAMINATION. The eligible list resulting from thisexamination will cancel any existing list and may last approximately one yearbut can be extended.Applications must bein the possession of the Human Resource Services Department by 5:00:00 p.m. onthe Last Day for Fi...

Position SummaryThe Database Sustainment Specialist (DSS) provides comprehensive sustainment maintenance reconciliation and data integrity support for Bureau of Medicine and Surgery (BUMED) Facility Management databases and related enterprise systems. The DSS is responsible for maintaining facility...