RN, Utilization Management - Remote, United States

· Description/Responsibilities · The Utilization Management Coordinator is responsible for supporting clinical, management, and client activities, comprising the UM Program. The Utilization Management Coordinator must be proficient in all UM processes such as pre-authorizations, ...

· Description/Responsibilities · The Utilization Management Coordinator is responsible for supporting clinical, management, and client activities, comprising the UM Program. The Utilization Management Coordinator must be proficient in all UM processes such as pre-authorizations, ...

We're excited you're considering an opportunity with us. Responsible for working in collaboration with the Medical Director on driving the decrease in care variance, to ensure timely discharges, and to refer members to other plan resources to meet their care conditions. · ...

About Us: · Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keep ...

About Us: · Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keep ...

The Specialist, Utilization Management provides operational support and subject matter expertise to ensure the effectiveness and continuous improvement of Accolade's Utilization Management program. · This role supports program execution by monitoring vendor process requirements, ...

· At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America's seniors. We prioritize preventive care while leveraging data and technology through the Clover Assistant, a powerful tool that helps physicians make ...

The Physician Advisor will play a critical role in SmarterDx's expansion into the Utilization Management space. This role will work closely with Product and Data Science teams to apply real-world physician judgment to the development of clinical logic, · Review and refine AI-gene ...

· The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team performance, accountability, and professional development by conducting regular 1:1s, managing performance reviews, and ...

· Job Summary · The Territory Manager is responsible for maximizing profitable sales growth within assigned geographies and accounts based within their territory. Results are achieved by leading, developing and executing agreed upon sales and marketing plans. · Essential Functio ...

Program Manager- Clinical Cost and Utilization · The Program Manager - Clinical Cost & Utilization is responsible for ensuring transparent, consistent, and ongoing progress across the clinical cost and utilization program and its related initiatives. This role provides leadershi ...

Job Description Summary · Customer facing staff responsible for winning business Impacts the team's ability to achieve service, quality and timeliness of objectives. Subject to Commercial policy objectives. Has independence in achieving commercial objectives within operating budg ...

· As the world and the way people live is changing we at Bekaert believe it's our responsibility to contribute to finding new solutions for the future.We aim to do this through innovative solutions and sustainable practices. · ...

We're looking for individuals who are not afraid to take risks and explore new ideas. · ...

+ Project Management: Work significantly affects multiple people within a limited number of areas/departments Responsible in all aspects of project planning including project proposal reviews to determine goals time frame funding project approach staffing requirements deliverable ...

We're looking for a certified pharmacy technician experienced in managed care specifically Part D/MAPD and who has had additional PBM collaboration relative to the administration of Part D and Part B pharmacy claims. · At Devoted Health, we're dedicated to providing personalized, ...

We're on a mission to improve the healthcare experience for everyone—starting with the people who deliver it. We help physicians focus more on patient care and less on paperwork through smarter technology, purpose-built tools, and a team-based model of care. · Conducting Initial ...

This position is responsible for obtaining authorizations for elective infusions and injections to financially clear patients and ensure reimbursement for the organization. ...

Why we exist · We're on a mission to improve the reliability, transparency, and efficiency of our energy systems, fostering a future with sustainable and abundant energy. To accomplish our aims, we're leveraging state of the art statistical learning and convex optimization method ...

Help us change lives at Exact Sciences where we give patients and clinicians the clarity needed to make confident decisions when they matter most.Join our team to find a purpose-driven career an inclusive culture and robust benefits to support your life while you\re working to he ...