Utilization Management RN - Remote

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. · ...

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, ...

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 Quality and Utilization Management Specialist will be responsible for interdepartmental coordination of monitoring and preparing submissions for initial and renewal of Utilization Review (UR) state licenses. · ...

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 ...

· 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 ...

· 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 ...

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 budgets and operating guidelines ...

· 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. · ...

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 ...

+ 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 ...

The Contractor shall provide a FRCS Cybersecurity Manager to install, configure, · calibrate operate maintain hardware software IT OT FRCS. · Bachelor of Science in Engineering Computer science or Information Systems · and 5+ years prior relevant experience · ...

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, ...

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

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 ...

At GENEWIZ from Azenta Life Sciences new ideas new technologies and new ways of thinking are driving our future Our customer-focused culture encourages employees to embrace innovation and challenge the status quo with novel thinking and collaborative work relationships · GENEWIZ ...

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 ...

Join us to be part of a forward-thinking people-centered company where your ideas and contributions truly matter. · ...

About City of Hope is to make hope a reality for all touched by cancer and diabetes. Founded in 1913, City of Hope has grown into one of the largest and most advanced cancer research and treatment organizations in the U.S., and one of the leading research centers for diabetes and ...

We're looking for a part-time Advisor for Utility Commission Strategy to shape how we engage state utility commissions and accelerate utility acceptance of our credit management solutions. · ...