RN Utilization Managment - Little Rock

To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here. · Job Summary · The Supervisor Utilization Management - Government Programs provides leadership and oversight to the utilization management team, ensuring day-to-day activities align with ...

Utilization Management: Conducts and monitors clinical review cases to ensure medical necessity of inpatient and outpatient services, diagnostic procedures, out-of-network services, and surgery; documenting all relevant and specific information; and screens, prioritizes and organ ...

To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here. · Job Summary · The Supervisor Utilization Management - Government Programs provides leadership and oversight to the utilization management team, ensuring day-to-day activities align with ...

The Pharmacy Utilization Management nurse performs clinical review of prior approvals and evaluates the appropriateness of pharmaceutical therapies for medical necessity. · Collaborates with healthcare providers to promote quality of care and cost effectiveness. · Conducts and mo ...

We are seeking a Clinical Care Manager who is passionate about advancing high-quality, compliant, patient-centered care through precise and timely Utilization Review. · Active, unrestricted Registered Nurse (RN) license in Illinois. · 5+ years of experience across varied healthc ...

Behavioral Health Utilization Management Medical Case Manager · CalOptima · Join Us in this Amazing Opportunity · The Team You'll Join · We are a mission driven community‐based organization that serves member health with excellence and dignity, respecting the value and needs of e ...

Description · The Manager, Utilization Management Intake Operations, is responsible for overseeing non-clinical intake and administrative support functions for the Utilization Management (UM) Department. This role provides leadership, operational oversight, and performance manage ...

Purpose statement: Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient's provider benefits for their needs. · ...

Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient's provider benefits for their needs. · ...

· Overview · PURPOSE STATEMENT: · Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient's provider benefits for their needs.  · Responsibilities · ESSENTIAL FUNCTIONS: · Provide consultation and guidance regarding admissi ...

Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient's provider benefits for their needs. · ...

Utilization Management Nurse performs clinical review of prior approvals and evaluates the efficiency and appropriateness of services for medical necessity through interpretation and review with evidenced-based criteria. · Bachelor's degree in Nursing preferred. · ,Registered Nur ...

The Manager, Utilization Management Intake Operations, is responsible for overseeing non-clinical intake and administrative support functions for the · Utilization Management (UM) Department. · This role provides leadership, · operational oversight, · and performance managementF ...

The Manager Utilization Management Intake Operations Non Clinical position is responsible for overseeing non-clinical intake and administrative support functions for the Utilization Management Department. · ...

We are recruiting Underground Utility Locators in your area. · The right individual will enjoy working outdoors, make a difference in the construction community, and take pride in completing a job well done. · ...

This position is responsible for expenditure accounting, record keeping and activity reporting functions to provide support for the Section's operation in processing utility reimbursements. · ...

This position is responsible for coordinating with utility owners for the relocation and adjustment of all utility facilities required to clear the right of way for highway construction and reconstruction projects. The coordinator will work with utility owners engineers in deter ...

The Clinical Pharmacist will report to and operate under the direction of Pharmacy Leadership.This position may be assigned to a specific scope and/or line of business (Care Management, Utilization Management, etc.) · Assists in development and supervises the drug utilization and ...

The Nursing Excellence Manager manages the daily operations of the Nursing Excellence team ensuring effective and efficient utilization of staff supplies and equipment Works collaboratively with other members of the team internal and external partners and stakeholders to create a ...

The Nursing Excellence Manager manages the daily operations of the Nursing Excellence team. Works collaboratively with other members to create a learning environment and education programs that meet individual and organizational goals. ...