a qualified Pharmacist to review Medicaid members’ Utilization Management requests, including formulary exceptions, prior... of this position. Responsibilities Review and evaluate Medicaid members’ Utilization Management requests. Apply clinical judgment...
by identifying and eliminating fraud, waste and abuse. This position will report directly to the Medical Review Supervisor... of medical terminology and experience in the analysis and processing of Medicare claims, utilization review/ quality assurance...
security. Job Title: Supervisor, Operations Management Job Code: 32876 Job Location: Londonderry, NH Job Schedule: 4/10..., etc.) so as to prevent damage Consult manufacturing engineers on any questions of proper handling Continually review and enforce the use...
expertise, the nursing process, current concepts/principles of case management/utilization management/disease management..., resource utilization, discharge planning and level of care. Management oversight of patient throughput: assessment...
successful candidate supervises the utilization management in accordance with the Hospital Utilization Review (UR) Plan, in addition... to join our team as a Supervisor-Care Management *BSN & RN Required; 3 years of relevant experience required*. In this role, the...
and maintenance of the daily functions of the following areas: Utilization Review/Review Nurses, Case Management, Medical Review...Summary We are currently hiring for a Behavioral Health Care Management Supervisor to join BlueCross BlueShield...
security. Job Title: Supervisor, Operations Management Job Code: 32279 Job Location: Londonderry, NH Job Schedule: 4/10..., etc.) to prevent damage. Consult manufacturing engineers on any questions of proper handling. Continually review and enforce the use...
practice experience; minimum of 3 years relevant utilization review, discharge planning, or case management experience... and the Case Management Assistants as to their performance with measurement expectations. Performs quality audits and review...
practice experience; minimum of 3 years relevant utilization review, discharge planning, or case management experience... and the Case Management Assistants as to their performance with measurement expectations. Performs quality audits and review...
practice experience; minimum of 3 years relevant utilization review, discharge planning, or case management experience... and the Case Management Assistants as to their performance with measurement expectations. Performs quality audits and review...
world-wide for a better future. Job Overview: The Intensive Case Management (ICM) Supervisor manages staff providing... direct client services within the ICM program. The ICM Supervisor plans and implements programming, coordinates core service...
Job Summary The Case Management Supervisor is responsible for the oversight of the case management staff... of the case manager's daily operations of utilization review practice, process and procedures ensuring accurate member care...
security. Job Title: Supervisor, Operations Management Job Code: 31436 Job Location: Londonderry, NH Job Schedule: 4/10..., etc.) to prevent damage. Consult manufacturing engineers on any questions of proper handling. Continually review and enforce the use...
management skills by participating in self-development activities such as seminars, workshops, classes and literature review... information about this position. Promotes the achievement of optimal clinical and resource utilization allocation, facilitates...
skills required. Computer literacy and proficiency. Familiarity with managed care and/or utilization management preferred..., training, evaluation and support to department staff in coordinating care and resource utilization. Serves as a role model...
Assistance programs is very strongly preferred. At least 2 years of management/supervisor experience (with direct reports...Anticipated End Date: 2026-02-01 Position Title: Licensed Manager I Care Management (Guilford Co) CFSP...
, Utilization Review, or VP. Shift(s) available: day shift, night shift, and mid shift Job types available: full time, part time... position: Nurse Manager - Case Management. Nurses with experience in any of the following areas are strongly encouraged...
Access Management (PAM) Division RCRs will provide exceptional customer service to our external customers: patients... and comprehensive information (both in writing and verbally) to patients, outside agencies and various administrative and management...
Job Seekers can review the Job Applicant Privacy Policy by clicking . Job Description: START ON A CAREER PATH.../Schedule- Monday through Friday 7AM to 330 PM Salary- Paid Weekly! Summary The Operations Management Trainee will support...
Summary of Position Perform clinical reviews within the Medical Management Operations Concurrent Review utilization... and maintain active working relationships with assigned facility care managers/utilization management departments to facilitate...