Utilization Management Specialist (UM / Utilization Review Nurse) Remote In this role, youll use your clinical background and utilization management experience to review requests for care and determine medical necessity, appropriateness, and benefit coverage. Youll work fully remote and leverage MCG,
Utilization Management Nurse - Emergency Department Conducts concurrent and retrospective chart review for clinical, financial, and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment. 1. Chart Review: Reviews the medical record by
Medical Director Oncology 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
Job Title Utilization Management Coordinator Company Description Experience the highest level of appreciation at UM Baltimore Washington Medical Center named Top Workplace in the Baltimore area by The Baltimore Sun two years in a row (2019 & 2020);
Health Services - Spec, Utilization Management Utilizing key principles of utilization management, the Utilization Review Specialist (BCBA Licensee) performs prospective, concurrent, and retrospective reviews to determine authorization, medical necessity, and appropriateness of ABA services. The Utilization Management Specialist leverages clinical expertise in behavior
Utilization Review Specialist (BCBA Licensee) Utilizing key principles of utilization management the Utilization Review Specialist (BCBA Licensee) performs prospective, concurrent, and retrospective reviews to determine authorization, medical necessity, and appropriateness of ABA services. The Utilization Management Specialist leverages clinical expertise in behavior
Utilization Management Coordinator Pay Range: $20.24hr - $24.24hr The Utilization Management Coordinator will provide administrative and operational support for utilization management activities, including authorization processing, benefit verification, claims inquiries, and coordination with members and providers. The role requires strong organizational skills, healthcare
Behavioral Health Analyst Pay Range: $46.76hr - $51.76hr Requirement/Must Have: Masters Degree or higher in Behavior Analysis, Psychology, Education, or a related field. Board Certified Behavior Analyst (BCBA) Required. Active state licensure as a Behavior Analyst
Job Title Pay Range: $46.76hr - $51.76hr Requirement/Must Have 5+ years Clinical nursing experience. 2+ years Care Management. Bachelors Degree in Nursing. Responsibilities Determines medical necessity and appropriateness by referencing regulatory mandates, contracts, benefit information, Milliman Care
Overview Johns Hopkins Intrastaff is the internal staffing agency for the Johns Hopkins Health System and partner hospitals, providing temporary support to a variety of the Johns Hopkins locations. Our employees are the strength of our
The Research Assistant oversees data collection, data organization, and/or data management or similar functions/tasks for research study(ies) in support of a PI or a research team. The Department of Health Policy and Management at the Johns Hopkins Bloomberg
Job Seekers can review the Job Applicant Privacy Policy by clicking here. Job Description: At Ryder, our most important competitive advantage is our people. As an Operations Management Trainee, you’ll be part of a dynamic team, equipped
Program Manager (SME) Behind every Census, every population estimates, every community funding decision, and every piece of geographic data used across the federal government is a foundation most people never see. The U.S. Census Bureaus (USCB)
Nurse Care Management Manager Step into an exciting, high-impact leadership role where innovation meets compassion, and take your career to the next level as a dynamic Nurse Care Management Manager guiding exceptional patient-centered outcomes in a thriving healthcare
Case Management Manager Opportunity Step into a leadership role at a large hospital in a big city where your expertise will shape patient outcomes, empower clinical teams, and elevate care coordination to the next level. The Case
Operations Management Trainee The Operations Management Trainee will support the shop management process and assist in cost savings, customer retention, and metric-based initiatives. This requires the Management Trainee to work cross functionally across Operations, Asset Management, Sales, Quality, and Rental. Essential
Supervisor, Operations Management (L2) We are seeking a dynamic first-shift leader to oversee production activities and drive operational success. The ideal candidate will provide coaching, resolve issues effectively, and support the day-to-day operations of assigned manufacturing production
Learning Management System, Sr. Program Manager Enterprise is a national nonprofit that exists to make a good home possible for the millions of families without one. We support community development organizations on the ground, aggregate and invest
Resource Management Manager The Resource Management Manager oversees workforce planning and scheduling processes across business lines, ensuring optimal resource alignment with financial goals and project demands. This role involves analyzing utilization data, coordinating staffing across regions, mentoring scheduling staff,
Lead Asset Management Administrator Overview Deloitte Technology US (DT-US), an internal enterprise technology organization within Deloitte, is seeking a Lead Asset Management Administrator to join the Software Asset Management team. In this role, you will support SAM initiatives that