- Rady Children's Hospital San Diego (San Diego, CA)
- …Utilization Management ( UM ) Operations & Member Services, the UM Operations Specialist will provide administrative support regarding operational ... departments, including UM Operations , and UM Clinical. The UM Operations Specialist is expected to have strong computer skills, the ability to… more
- AmeriHealth Caritas (Newtown Square, PA)
- …the Utilization Management Administrative Operations team, the Utilization Management Correspondence Quality Oversight Specialist will interface with ... UM delegates to conduct quality review of UM letters templates to confirm adherence with NCQA/Contractual requirements....experience. + RN or LCSW required.; + 3-5 years Utilization Management experience required.; + Displays good judgment in… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …and writing of medical policies, working closely with utilization management ( UM ) to promote usability. The MP Clinical Specialist monitors and updates ... our Healthsource blog: https://healthsource.premera.com/ . The **Medical Policy (MP) Clinical Specialist ** is a critical role in Premera, responsible for the… more
- LA Care Health Plan (Los Angeles, CA)
- …achieve that purpose. Job Summary The Supervisor, Authorization Technician supports the Utilization Management ( UM ) Specialist by handling all administrative ... ,Healthcare Common Procedure Coding System (HCPCs) codes. Technical Support to UM Specialist : Processing of time sensitive authorization and pre-certification… more
- The Arora Group (Bethesda, MD)
- …Care Managers: Care Manager Certified (CMC) + Experience: + Referral Management/ Utilization Management (RM/ UM ) experience. + Clinical subspecialty experience in ... Registered Nurse (RN) Case Manager to work the Directorate of Healthcare Operations (DHO) at Walter Reed National Military Medical Center, Bethesda, Maryland.… more
- Sharp HealthCare (Santee, CA)
- …to meet billing requirements daily.Follows policies and procedures for all Utilization Management ( UM ), discharges, Standardized Outcome Measures, Durable ... it to the PT Supervisor, supervisor point of contact, or supporting clinical specialist (PT Spec III) for resolution in a timely manner.Consults and listens,… more
- University of Miami (Miami, FL)
- …and promotes a process for coloration, cooperation, and teamwork. + Monitors utilization patterns of laboratory services and advises leadership and other appropriate ... medicine. + Participates in the development and implementation of an operations budget to ensure compliance with organizational expenditure requirements. + Leads… more
- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500009 Utilization Management Work Shift: UR - Day (United States of America) Range: UR ... thorough knowledge of department coding policies and procedures, oversees office operations , assists in administering personnel related duties and acts as the… more