Utilization Management Jobs in Douglas Qld

Are you a proven sales leader who thrives at the intersection of cloud innovation and healthcare transformation Amazon Web Services (AWS) is seeking a Senior Sales Leader to lead our US Healthcare and Life Sciences (HCLS) Payors this role you will build lead and develop a high-performing team of Se...

The Chief Medical Officer (CMO) for the Value-Based Services Organization (VBSO) serves as a senior clinical leader supporting the advancement of value-based care across the health system. The role focuses on improving quality clinical outcomes patient experience and total cost of care across define...

Who We ArePoint32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality affordable healthcare. Serving nearly 2 million members Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and em...

DescriptionWe are seeking a strategic and results-oriented Technical Program Manager (TPM) to lead the TPM function for the Enterprise Data Platform for Analytics and AI and drive the end-to-end development and implementation of high-impact technical projects and this role you will serve as a criti...

Job Family:Medical AssistantTravel Required:NoneClearance Required:NoneWhat You Will Do:Receive triage and prioritize denied hospital claims based on timely filing requirements financial impact and payer response deadlines. Conduct root cause analysis to identify clinical documentation authorization...

Anticipated End Date:Position Title:RN Utilization Management Nurse (InPatient) California HMOJob Description:RN Utilization Management Nurse (InPatient) California HMOVirtual:This role enables associates to work virtually full-time with the exception of required in-person training sessions provid...

DescriptionPosition at Nuvance Health Med Practice PCOBGYN HospitalistopportunityatVassarBrothers Medical Centerin Poughkeepsie NY (75 minutes North of New York City)Vassar Brothers Medical Center(VBMC)ofNuvanceHealth proudly joining Northwell Healthlocatedjust 75 minutes north of New YorkCityis see...

Join us as a Utilization Review Clinician!Schedule: Monday - Friday 40 hours onsite. As a Utilization Review Clinician for MiraVista in Holyoke Massachusetts youll bring your experience and knowledge where your voice matters. A Utilization Review Clinician is an integral part of our multidisciplinar...

Position: RN Care Coordinator-Complex Case Manager Department: Care ManagementSchedule: Full Time 10am-6pmEXPERIENCE:3-5 years of diversified clinical experience is required certification preferredA minimum of 2 years of previous experience involving judgment and decision making preferably in a util...

We are seeking a passionate Care Manager I - LVN to join our Population Health team in the Houston Texas this full-time role you will play a key part in coordinating care supporting patients through transitions of care and addressing barriers that impact overall health and wellness.As a Care Manage...

Find your calling at Mercy!The RN Care Manager II - IPCM as part of the interdisciplinary team assesses plans advocates and coordinates care from admission to discharge ensuring a safe transition post-hospitalization. This role involves assessing patients health needs developing individualized care...

Hours:Shift Start Time:8 AMShift End Time:4:30 PMAWS Hours Requirement:8/80 - 8 Hour ShiftAdditional Shift Information:Weekend Requirements:As NeededOn-Call Required:NoHourly Pay Range (Minimum - Midpoint - Maximum):$61.740 - $70.170 - $90.160The stated pay scale reflects the range as defined by the...

Title: RN Case ManagerLocation: Santa Rosa CADuration: 13 weeksShift: 8*5/ DaysJob OverviewThe Case Manager RN is responsible for coordinating patient care ensuring appropriate utilization of healthcare services and supporting discharge planning. The role involves collaboration with interdisciplinar...

DescriptionPosition at Northwell HealthPART TIME- 20 hours per week- Mon-Fri 8pm- 12am shift- Rotating weekends and holiday coverage expected!Northwell is the largest not-for-profit health system in the Northeast serving residents of New York and Connecticut with 28 hospitals more than 1000 outpatie...

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...

Department InformationThis position is open to current Colorado residents onlyAbout Fort Logan:The Colorado Mental Health Hospital at Fort Logan (CMHHIFL) is one of two state hospitals serving our community. The vision of CMHHIFL is to provide the highest quality mental health services to persons wi...

Requisition Number: 513826Join our North Memorial Health OB/GYN Hospitalist Provider Team!If youre looking to join a team that works collaboratively has a calling to empower patients to achieve their best health and delivers unmatched customer service you might be the next North Memorial Health OB/G...

Employment Type:Full timeShift:Description:***Prior experience with healthcare IT systems (e.g. claims management enrollment management utilization management) is essential and required.******Employee must be within driving distance of the Columbus Ohio region in order to make on-site visits once pe...

Weve made a lot of progress since opening the doors in 1942 but one thing has never changed - our commitment to serve heal lead educate that every award earned every record broken and every patient helped is because of the dedicated employees who fill our hallways. At Ochsner whether you work with...

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC your contributions matter and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% p...