Utilization Review Manager Jobs Near Me

Care Review Nurse Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing ...

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing healthcare members ...

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...

Well versed in Utilization Management - Must be able to determine elective vs urgent request with Prior Authorization Review * Provider Claims, Appeals and Denials - certain services require prior ...

SUMMARY The Utilization Management Specialist is responsible for coordinating and managing all ... Monitors and reviews MCO portals to track authorization status, pending requests, approvals ...

Experience in utilization review, case management, medical records, or healthcare billing strongly preferred * Strong understanding of insurance authorization processes (Medicare, Medicaid, and ...

Care Review Clinician Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at ...

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...

For billing and hospitalization utilization review purposes, the reviewer will identify and certify ... Maintain compliancy with regulation changes affecting utilization management. PositionRequirements ...

Experience: 0-2 years of experience in a Utilization Review Department in a Managed Care Environment. Previous Hospital or Healthcare clerical, audit or billing experience. Qualifications High School ...

Experience: 0-2 years of experience in a Utilization Review Department in a Managed Care Environment. Previous Hospital or Healthcare clerical, audit or billing experience. Qualifications High School ...

High School Diploma/GED Required Experience: 0-2 years of experience in a Utilization Review Department in a Managed Care Environment. Previous Hospital or Healthcare clerical, audit or billing ...

Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as: * MCG- Milliman Care Guidelines * R1- Physician Advisor * Payer Portal Administrator

Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as: * MCG- Milliman Care Guidelines * R1- Physician Advisor * Payer Portal Administrator

Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...

Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...

Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...

Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as: * MCG- Milliman Care Guidelines * R1- Physician Advisor * Payer Portal Administrator

We deliver strategic workforce solutions that help you manage your talent and business more ... utilization review for other healthcare services * Checks eligibility and verifies benefits ...