- Excellus BlueCross BlueShield (Rochester, NY)
- …encourage you to apply! Job Description: Summary: This position supports the Utilization Management (UM) workflows by providing administrative support and ... attendance is expected and required. + Performs other functions as assigned by management . Level II (in addition to Level I Accountabilities) + Assists and performs… more
- Elevance Health (Columbus, GA)
- **Title: Utilization Management Representative I** **Location:** This position will work a remote model. Ideal candidates will live within 50 miles of one of ... our PulsePoint locations. The ** Utilization Management Representative I** will be responsible for coordinating cases for precertification and prior… more
- Elevance Health (TX)
- …and personalized support throughout the consumer's treatment journey. **Title:** Utilization Management Representative Lead **Location:** Onsite ... Elevance Health location. **Build the Possibilities. Make an extraordinary impact.** The Utilization Management Representative Lead is responsible for… more
- Elevance Health (Miami, FL)
- ** Utilization Management Representative I** **Location: Candidates must be located within 50 miles of Miami, FL and will be required to work onsite 1-3 times ... Monday-Friday 8am-5pm OR 8:30am-5:30pm** **Bilingual in Spanish Strongly Preferred** The ** Utilization Management Representative I** is responsible for… more
- Matrix Providers (Aurora, CO)
- …in Handbook) + 401(k) Plan Minimum Requirements Registered Nurse (RN) Utilization Management : Degree/Education: Bachelor-s degree in nursing. Certifications: ... Case Management through the American Nurses Credentialing Center + Utilization Management Accreditation through National Committee for Quality Assurance… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …preferred Experience: Greater than 3 years clinical nursing experience required. Utilization management experience preferred. Must be self-directed and possess ... clinical expertise with knowledge of medical appropriateness criteria, and applies principles of utilization and quality management , and the management of… more
- Brockton Hospital (Brockton, MA)
- … program that enhances the quality of patient care while optimizing resource utilization . Provides training to staff on case management methods and techniques. ... systems, plans and develops reports that clearly monitor all areas of utilization /case management . Provides data, guidance and input on the development… more
- University of Rochester (Strong, AR)
- …of Medicare and other payer regulations for the coordination of benefits. + Notify Utilization Management of clinical requests by third party payers. + Maintain ... Counseling, Medicaid Enrollment & Outreach, Financial Assistance, Registration and Insurance Management , Utilization Management , Social Work, Patient… more
- Boehringer Ingelheim (Denver, CO)
- …along with further development of technical product knowledge is imperative. Effective utilization and management of internal and external resources is expected. ... records concerning activities; communicates timely, accurately and meaningfully with Management . Utilizes CRM tool and supporting analysis to plan activity,… more
- Cedars-Sinai (CA)
- …workflows. + As liaison coordinates administrative support activities including facilities management , patient billing, utilization management , quality ... **Job Description** The Senior Patient Service Rep is responsible for positive patient relations, accurate...plans and other departments. + Actively participate in lean management processes by detailing, monitoring and updating department specific… more