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
About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member’s benefit coverage while working remotely. Primary Responsibilities •
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
ABOUT THE ROLE: The Pharmacy Technician (CPhT) – Utilization Management is a member of the RightwayRx Operations team. This role will assist UM leadership in delivering on our UM strategy and actively work UM cases. Our pharmacy benefit
Description Who We Are - Motivated by Purpose. Powered by Clinical Expertise. Founded in 1983, we’re a clinically driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to healthcare organizations. Excellence starts with
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.
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.
Hi, were Oscar. Were hiring a part-time Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on
Senior Utilization Management Assistant - REMOTE. This position is Full-time and will work 8-hour, Day/ Variable shifts. Under the supervision of Regional Director of Care Management, the Utilization Management Coordinator is responsible for providing support to the Care Management team who coordinates
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
Become a part of our caring community Humana Healthy Horizons in Kentucky is looking for a Utilization Management Behavioral Health Professional 2 who uses behavioral health knowledge and skills to support the coordination, documentation, and communication of medical
Join us for an exciting career with the leading provider of supplemental benefits! Our Promise Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues
Molina Healthcare is hiring a Pharmacist in our Utilization Management/Prior Auth department. This position will be working Monday through Friday from 10:00am to 6:30pm CST with rotating weekends and holidays. Candidates can be licensed in any state but
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves
City/StateNorfolk, VA Work ShiftWeekend Days Overview: Sentara Health Plans is hiring a Behavioral Health Utilization Management Clinician/LCSW/LPC/LMFT/RN for Substance Abuse - Flexible Weekend Dayshift - Remote in VA and NC! Status: Full-time, permanent position (40 hours) Work hours:
Job Description Job Type: Part-time Contractor Required Skills and Experience: Broad state licensure coverage Medicare Utilization Management experience Comfort with learning and adapting to new technologies Willingness to obtain other state licenses Your Responsibilities will include: Perform clinical
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 has
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves