utilities manager - Huntington Beach, CA

Description · The UM Nurse Manager is responsible for providing strategic and operational leadership to the day to day function of the Utilization Management Team. The UM Nurse Manager will ensure that the team complies with timeliness, documentation, notification and review qual ...

The UM Nurse Manager is responsible for providing strategic and operational leadership to the day to day function of the Utilization Management Team.Ensures that staff achieves performance goals while adhering to applicable internal and external policies procedures rules and guid ...

*JOB DESCRIPTION* · The UM Nurse Manager is responsible for providing strategic and operational leadership to the day to day function of the Utilization Management Team. The UM Nurse Manager will ensure that the team complies with timeliness, documentation, notification and revie ...

The UM Nurse Manager is responsible for providing strategic and operational leadership to the day to day function of the Utilization Management Team.The role involves ensuring compliance with timeliness, documentation, notification and review quality standards based on Federal St ...

The UM Nurse Manager is responsible for providing strategic and operational leadership to the day to day function of the Utilization Management Team · Ensures that the team are properly trained to conduct medical necessity reviews on incoming Pre-Service/Prior-Authorization, Retr ...

The UM Nurse Manager is responsible for providing strategic and operational leadership to the day to day function of the Utilization Management Team. Ensures that staff achieves performance goals while adhering to applicable internal and external policies, procedures rules and gu ...

WearelookingforanexperiencedUtilizationManagementAppealsReviewNursetojoinourteam.TheidealcandidatewillhaveaprofessionallicensureasLVNorRNandatleasttwoyearsofexperienceinutilizationmanagement. · ...

Astiva Health Inc is looking for a highly energetic and collaborative Utilization Management Manager to foster an environment of excellence in servicing Astiva Health's members. · ...

This role enables associates to work virtually full-time with maximum flexibility and autonomy. · Managing incoming calls from clients needing mental health and substance use services. · ...

This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill deve ...

Akido builds AI-powered doctors. Akido is the first AI-native care provider, combining cutting-edge technology with a nationwide medical network to address America's physician shortage and make exceptional healthcare universal. Its AI empowers doctors to deliver faster, more accu ...

The Opportunity: The UM Coordinator will support the Utilization Management function of multiple IPAs in the Inland Valley area to proactively monitor utilization of services for patients. · ...

The Utilization Management Appeals Review Nurse is responsible for conducting comprehensive clinical and regulatory reviews of hospital admission appeals. · This role ensures that appeal determinations are clinically appropriate, fully documented, · and compliant with CMS requir ...

Akido builds AI-powered doctors. Akido is the first AI-native care provider, combining cutting-edge technology with a nationwide medical network to address America's physician shortage and make exceptional healthcare universal. Its AI empowers doctors to deliver faster, more accu ...

Akido builds AI-powered doctors. Akido is the first AI-native care provider, combining cutting-edge technology with a nationwide medical network to address America's physician shortage and make exceptional healthcare universal. Its AI empowers doctors to deliver faster, more accu ...

Akido builds AI-powered doctors. Akido is the first AI-native care provider, combining cutting-edge technology with a nationwide medical network to address America's physician shortage and make exceptional healthcare universal. Its AI empowers doctors to deliver faster, more accu ...

· Akido builds AI-powered doctors. Akido is the first AI-native care provider, combining cutting-edge technology with a nationwide medical network to address America's physician shortage and make exceptional healthcare universal. Its AI empowers doctors to deliver faster, more a ...

This role enables associates to work virtually full-time with maximum flexibility and autonomy. · Managing incoming calls or post services claims work. · Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prio ...

· The Opportunity · We are seeking a Senior UM & Claims Manager to lead and oversee Utilization Management and Claims operations across multiple IPAs supported by our MSO in Southern California. Reporting to the Head of AI Operations (COO of the MSO), this role is critical to e ...

A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options offers superior clinical mental health and substance use disorder management. · Requires HS diploma or equivalent and a minimum of 2 years customer service experie ...