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
WHO WE ARE NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help
At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors. We prioritize preventive care while leveraging data and technology through the Clover Assistant, a powerful tool that helps physicians
Become a part of our caring community The UM Administration Coordinator (UMAC) provides non-clinical support for policies ensuring the most appropriate treatment, care or services for members using services. Reporting to the Manager of Utilization Management, you will
Medical Director, Utilization Management The Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and payment policy to accelerate the emergence of a value-based health care system in California. The Medical Director, Utilization Management will
Job Description The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our Medi-Cal and Medicare populations. The Utilization Management Manager will report to
Job Description The Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical necessity, coding accuracy, treatment plans, discharge planning, and compliance requirements while supporting clinical consistency, process improvement, quality, timeliness,
We are so glad you are interested in joining Sutter Health! Organization:MPHS-Mills-Peninsula Medical Center Position Overview:Acts independently to perform and coordinate all activities related to the billing, denials, and appeals of all types. Reports out monthly
BeOne continues to grow at a rapid pace with challenging and exciting opportunities for experienced professionals. When considering candidates, we look for scientific and business professionals who are highly motivated, collaborative, and most importantly, share our
Job Description We are seeking an exceptionally skilled RN Case Manager to join our dedicated Case Management team. This position offers an outstanding opportunity to work in a dynamic inpatient setting where you will plan and coordinate
Become a part of our caring community The Risk Management Professional 2 is responsible for leading and executing quality audits within the CenterWell Utilization Management (UM) program, ensuring compliance with regulatory requirements, including CMS and NCQA standards. This role
Are you looking for a role that motivates and challenges you? Are you ready for an opportunity for growth? Do you want to work on teams where people roll up their sleeves to take on tough
Location: San Francisco, CA, United States Job ID: 89667 We Elevate. Quality of urban life Our elevators, escalators, and moving walks safely transport more than two billion of us up and down buildings and across transportation
Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists
Introduction At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they’re free to grow, lead, and innovate. You’ll be backed by our digital ecosystem: a client-centric suite of
Manager Of Category Management Are you a strategic procurement leader with a passion of driving performance, building teams, and delivering results in a complex healthcare environment? Stanford Healthcare is seeking an experienced Manager of Category Management to lead
Job Summary: Develops and monitors the social services programs for the CSA. Establishes and maintains, standards, quality levels, cost effective, and customer focused services. Establishes interfaces with community services. Essential Responsibilities :Plans, develops, implements and maintains
Regional Delivery Leader For America West Uniphore is at an inflection point. The platform is mature, the market is moving, and enterprise customers are ready to deploy agentic AI at scale but only with a delivery
Medical Case Management Nurse The Medical Case Management Nurse (MCM Nurse) provides a variety of services with respect to medical care review, cost containment, claims review, appeals and grievances, and analytical reporting. As part of our Medical Management Team,
Manager Social Services Case Management - LCSW - Emergenc... Hiring Immediately
Job Summary: Develops and monitors the social services programs for the CSA. Establishes and maintains, standards, quality levels, cost effective, and customer focused services. Establishes interfaces with community services. Essential Responsibilities: Plans, develops, implements and