Job DetailsJob Location: Huntington Beach Office - Huntington Beach, CA 92647Position Type: Full TimeSalary Range: $34.98 - $42.85 HourlyRemote in California onlyAre you ready to make a lasting impact and transform the healthcare space? We are
Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine
JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired
JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified with at risk or high utilization needs. Functions
JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified with at risk or high utilization needs. Functions
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the
JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired
Become a part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations for Humana’s Kentucky Medicaid Plan. This role
Relief, Variable Pay range: $48.30 - $72.45 ST. CHARLES HEALTH SYSTEM JOB DESCRIPTION TITLE: RN Utilization Management REPORTS TO POSITION: Manager- Utilization Management DEPARTMENT: Utilization Management DATE LAST REVIEWED: November 2024 OUR VISION: Creating America’s healthiest community, together OUR MISSION:
Utilization Review RN - Remote. This position is Part-time and will work 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical records daily during admission for all
Overview Who We Are Because health is personal. Thats why Personify Health created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. We serve
Job Title Plays a critical role in ensuring that patients receive high-quality care while efficiently utilizing medical resources. Job Description Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in
Director of Utilization Management The Director of Utilization Management (UM) is responsible for leading and managing the Utilization Management (UM) functions at Northeast Georgia Medical Center. This position plays a critical role in ensuring correct status assignment, optimizing reimbursement,
Job Description Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through
Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations, URAC standards, and Guidehealth policies. This role applies established medical necessity criteria to obtain,
Job Title Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through
Utilization Review Specialist The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote cost-effective quality care and cost containment in accordance with various federal and/or
Sr Utilization Management Nurse Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting
At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We
At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health